| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD STE 100 ROCHESTER, NY 14623 | EXCELLUS BLUE CROSS BLUE SHIELD | $59K | — | $59K | 1.36% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $50K | — | $50K | 1.15% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD STE 100 ROCHESTER, NY 14623 | EXCELLUS BLUE CROSS BLUE SHIELD | $10K | — | $10K | 1.81% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $10K | — | $10K | 1.79% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD STE 100 ROCHESTER, NY 14623 | EXCELLUS BLUE CROSS BLUE SHIELD | $6K | — | $6K | 2.28% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $5K | — | $5K | 2.10% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $4K | $3K | $7K | 5.75% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $3K | — | $3K | 2.92% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $2K | $1K | $3K | 6.00% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 2.92% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. OF NY | $2K | — | $2K | 7.81% |
| USI INSURANCE SERVICES LLC3 | 726 EXCHANGE ST BUFFALO, NY 14210 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 6.79% |
| CHARLES MORALES3 | 39 SAGINAW DR ROCHESTER, NY 14623 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $1K | $26 | $1K | 4.19% |
| STEPHEN C PLATNER3 | 11 CHESHAM WAY FAIRPORT, NY 14450 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $1K | $24 | $1K | 3.45% |
| KAITLYN M PARTLOW3 | 10 HYACINTH LN FAIRPORT, NY 14450 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $545 | — | $545 | 1.81% |
| SHANE STICKLE3 Filed as: SHANE S STICKLE | 6787 VAIL DR HAMBURG, NY 14075 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $481 | $6 | $487 | 1.61% |
| BRENDAN MCCARTHY AND CREW INC3 | 39 SAGINAW DR STE 2 ROCHESTER, NY 14623 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $294 | — | $294 | 0.97% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $95 | — | $95 | 0.31% |
| RICHARD DE ASIS3 | 39 HUNTERS RUN PITTSFORD, NY 14534 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $68 | — | $68 | 0.23% |
| TERESA STRONG3 | 1070 SKATES ST THE VILLAGES, FL 32163 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $68 | — | $68 | 0.23% |
| DEBRA M PARKER3 | 20 BOWEN ST AUBURN, NY 13021 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $59 | — | $59 | 0.20% |
| MEAGAN L KIRCHGESSNER3 | 1116 PECK RD HILTON, NY 14468 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $50 | — | $50 | 0.17% |
| NICHOLAS J DELIA3 | 165 ARMSTRONG RD SYRACUSE, NY 13209 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $47 | — | $47 | 0.16% |
| ANDREW THOMAS3 Filed as: ANDREW C THOMAS | 4802 BURRSTONE RD SYRACUSE, NY 13215 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $40 | — | $40 | 0.13% |
| JOSEPH P CALARCO3 | PO BOX 130 AUBURN, NY 13021 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $34 | — | $34 | 0.11% |
| BENEFIT RESOURCE GROUP LLC3 Filed as: BENEFIT RESOURCE INC | 2320 BRIGHTON HENRIETTA TNLN RD ROCHESTER, NY 14623 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $33 | — | $33 | 0.11% |
| MICHAEL O'MAY3 | 136 GREENFIELD RD ROCHESTER, NY 14626 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $32 | — | $32 | 0.11% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $22 | — | $22 | 0.07% |
| EDWARD B LEAHY III3 | 85 ALLEN ST STE 210 ROCHESTER, NY 14608 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $19 | — | $19 | 0.06% |
| JEFFREY R DALABA3 | 8500 GILLY FLOWER CT BALDWINSVILLE, NY 13027 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $17 | — | $17 | 0.06% |
| PAUL SAMUEL OWENS3 | 279 RIVER ST ROCHESTER, NY 14612 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $16 | — | $16 | 0.05% |
| DANIEL P DUPRE3 | 4 BEDFORD WAY PITTSFORD, NY 14534 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $16 | — | $16 | 0.05% |
| LEWIS K GATHRIGHT JR3 | 276 FAIRPORT VILLAGE LANDING FAIRPORT, NY 14450 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $10 | — | $10 | 0.03% |
| KELLY A IRVINE3 Filed as: KELLY ANN IRVINE | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $9 | — | $9 | 0.03% |
| BRAD JONES AND ASSOCIATES INC3 | 19 BRITISH AMERICAN BLVD W LATHAM, NY 12110 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $7 | — | $7 | 0.02% |
| LAURA ANNE CALARCO3 | 340 HORSE CREEK DR APT 208 NAPLES, FL 34110 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $6 | — | $6 | 0.02% |
| STEVEN E DALABA3 Filed as: STEVEN A DALABA | 7683 SEDGEWICK RIDGE RD LEWISVILLE, NC 27023 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $6 | — | $6 | 0.02% |
| TIMOTHY HENDERSON3 Filed as: TIMOTHY P HENDERSON | 13 WILD LAUREL LN HILTON HEAD, SC 29926 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $5 | — | $5 | 0.02% |
| CORIN MCMANUS3 | 2402 WESTSIDE DR NORTH CHILI, NY 14514 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $5 | — | $5 | 0.02% |
| KEVIN MURPHY3 | 11 WILLOWBROOK TER CLIFTON PARK, NY 12065 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $2 | — | $2 | 0.01% |
| FRANK J. MOLEY3 Filed as: FRANK J MOLEY | 5646 HIDDEN LAKE DR LOCKPORT, NY 14094 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $2 | — | $2 | 0.01% |
| LAURIE L SMITH3 | 577 TRUESDALE HILL RD LAKE GEORGE, NY 12845 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $2 | — | $2 | 0.01% |
| JOHN B INFERRERA3 | 174 GARNSEY RD PITTSFORD, NY 14534 | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | $2 | — | $2 | 0.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $155 | $111 | $266 | 6.02% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $129 | — | $129 | 2.92% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT INSURANCE CO | $113 | $17 | $130 | 17.33% |
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 | 436 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 436 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | EXCELLUS BLUE CROSS BLUE SHIELD | 237 | $4.9M |
| Dental | EXCELLUS BLUE CROSS BLUE SHIELD | 310 | $249K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. OF NY | 247 | $31K |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 571 | $118K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 370 | $50K |
| Prescription drug(2 contracts) | EXCELLUS BLUE CROSS BLUE SHIELD | 237 | $4.9M |
| Other(3 contracts, 3 carriers) | AMERICA FAMILY LIFE INSURANCE COMPANY OF NEW YORK | 571 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 571 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.