| 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 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $32K | — | $32K | 4.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $75 | $75 | 0.02% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $7K | — | $7K | 2.60% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | — | $914 | $914 | 0.37% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | SUN LIFE AND HEALTH INSURANCE COMPANY | $9K | — | $9K | 3.52% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY, INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $4K | — | $4K | 2.42% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $645 | $645 | 0.36% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $10K | — | $10K | 5.70% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY, INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | VISION SERVICE PLAN | $3K | — | $3K | 2.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 SELF FUNDED MEDICAL | Claims processing Service code 12 | — | $356K |
| DELTA DENTAL OF NEW YORK EIN 11-1980218 SELF-FUNDED DENTAL | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $30K |
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 | 984 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 984 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 1,445 | $10.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 798 | $641K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,272 | $190K |
| Life insurance(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,262 | $917K |
| Short-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 757 | $180K |
| Long-term disability(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,262 | $922K |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUECROSS BLUESHIELD | 643 | $173K |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,262 | $917K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,445 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.