| 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 | $15K | $9K | $24K | 9.71% |
| NATIONAL BENEFIT CENTER3 | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $165 | — | $165 | 0.07% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | $342 | — | $342 | 4.10% |
| 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) | $58 | — | $58 | 0.70% |
| FINANCIAL ALTERNATIVES INC3 | 7527 WOODCREST ROAD BALDWINSVILLE, NY 13027 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | $39 | — | $39 | 0.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 DENTAL CLAIMS ADMIN | Claims processing; Contract Administrator Service code 12 | — | $177K |
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 | 552 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 552 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 552 | $245K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 552 | $245K |
| Short-term disability | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | 7 | $8K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 552 | $245K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 552 | — |
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.