| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES (PA INC | 2600 KELLY RD #300 WARRINGTON, PA 18976 | SYMETRA LIFE INSURANCE COMPANY | $19K | $13K | $32K | 8.13% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 5.58% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES (PA) INC | 2600 KELLY RD #300 WARRINGTON, PA 18976 | SYMETRA LIFE INSURANCE COMPANY | $1K | $900 | $2K | 8.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 SELF-FUNDED MEDICAL | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $474K |
| DELTA DENTAL OF NEW YORK EIN 11-1980218 SELF-FUNDED DENTAL | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $44K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,339 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 345 | $49K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 1,339 | $394K |
| Short-term disability(2 contracts) | SYMETRA LIFE INSURANCE COMPANY | 1,339 | $422K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 1,339 | $394K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 1,339 | $394K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,339 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.