| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FARIPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $31K | — | $31K | 3.40% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK STE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $8K | — | $8K | 7.33% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY | 400 WILLOWBROOK OFFICE PARK STE 400 FAIRPORT, NY 14450 | CIGNA GROUP INSURANCE | $3K | $499 | $3K | 15.80% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK STE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $1K | $3K | 13.98% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY | 400 WILLOWBROOK OFFICE PARK STE 400 FAIRPORT, NY 14450 | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 14.59% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | — | $491 | $491 | 5.02% |
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 | 312 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 312 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 117 | $911K |
| Dental | EXCELLUS BLUECROSS BLUESHIELD | 145 | $107K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 127 | $21K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | 312 | $10K |
| Long-term disability | CIGNA GROUP INSURANCE | 132 | $22K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 117 | $911K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | 312 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
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.