| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $104K | — | $104K | 2.54% |
| 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 | $10K | $12K | $22K | 6.07% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | $3K | $1K | $5K | 17.23% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | $1K | $4K | 23.29% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $615 | $615 | 4.00% |
| RELPH ROBERT G AGENCY INC3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | THE HARTFORD | $1K | — | $1K | 17.00% |
No Schedule C service providers reported on this filing.
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 | 825 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 825 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 549 | $4.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 563 | $368K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 563 | $368K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | 825 | $27K |
| Long-term disability | THE HARTFORD | 26 | $8K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 549 | $4.1M |
| Other(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | 825 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 825 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.