| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $11K | — | $11K | 3.74% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | HARTFORD LIFE AND ACCIDENT | $13K | — | $13K | 5.91% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | $766 | — | $766 | 12.09% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK | 45 EAST AVE ROCHESTER, NY 14604 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | $101 | — | $101 | 1.59% |
| FINANCIAL ALTERNATIVES INC3 | 7527 WOODCREST ROAD BALDWINSVILLE, NY 13027 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | $40 | — | $40 | 0.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 CLAIMS ADMINISTRATION | Claims processing; Contract Administrator Service code 12 | — | $0 |
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 | 436 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 436 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EXCELLUS BLUECROSS BLUESHIELD | 406 | $289K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 553 | $226K |
| Short-term disability | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | 5 | $6K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 553 | $226K |
| Other | HARTFORD LIFE AND ACCIDENT | 553 | $226K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 553 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.