| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 5.63% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY NORTH STE 500 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $13K | $13K | 3.90% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $179 | $2K | 12.82% |
| ROBERT G. RELPH AGENCY, INC.3 | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | $446 | — | $446 | 5.56% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 3700 PARK E DRIVE STE 350 BEACHWOOD, OH 44122 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | — | $20 | $20 | 0.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 MEDICAL/RX CLAIMS ADMIN | Claims processing Service code 12 | — | $230K |
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 | 635 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 635 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 76 | $327K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 635 | $324K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 635 | $324K |
| Short-term disability | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (UNUM) | 7 | $8K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 635 | $324K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 635 | $338K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 635 | — |
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.