| 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 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 6.57% |
| ALLIANCE ADVISORY GRP INC3 Filed as: ALLIANCE ADVISORY GROUP INC. | 600 DELAWARE AVE BUFFALO, NY 14202 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $148 | — | $148 | 0.07% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | HARTFORD LIFE AND ACCIDENT | $435 | — | $435 | 2.63% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | $657 | — | $657 | 7.75% |
| 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) | $63 | — | $63 | 0.74% |
| FINANCIAL ALTERNATIVES INC3 | 7527 WOODCREST ROAD BALDWINSVILLE, NY 13027 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | $43 | — | $43 | 0.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 DENTAL CLAIMS ADMIN | Claims processing; Contract Administrator Service code 12 | — | $173K |
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 | 553 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 553 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 548 | $201K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 553 | $218K |
| Short-term disability | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | 6 | $8K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 553 | $17K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 553 | $218K |
| 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."
No prospect flags tripped on this filing.