| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 | 800 PARKER HILL DR. SUITE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $45K | — | $45K | 2.71% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 1416 SWEET HOME RD SUITES 5/6 AMHERST, NY 14228 | EXCELLUS BLUE CROSS BLUE SHIELD | $19K | — | $19K | 1.14% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $2K | $850 | $2K | 8.56% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 7789 OSWEGO RD LIVERPOOL, NY 13090 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.42% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | — | $729 | $729 | 2.56% |
| RELPH ROBERT G AGENCY INC3 Filed as: RELPH ROBERT G AGENCY INC. | 800 PARKER HILL DR. SUITE 100 ROCHESTER, NY 14625 | THE GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 5.79% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 3 PARKWAY N STE 500 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY | — | $874 | $874 | 3.21% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 1416 SWEET HOME RD SUITES 5/6 AMHERST, NY 14228 | THE GUARDIAN LIFE INSURANCE COMPANY | $535 | $32 | $567 | 2.08% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 800 PARKER HILL DR #100 ROCHESTER, NY 14625 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 8.36% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC. | 3 PARKWAY N SUITE 500 DEERFIELD, IL 60015 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $970 | — | $970 | 3.66% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DR #200 HUNT VALLEY, MD 21030 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $609 | — | $609 | 2.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFETIME BENEFIT SOLUTIONS EIN 16-1171765 TPA | Claims processing; Contract Administrator Service code 12 | — | $6K |
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 | 204 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 137 | $1.7M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 121 | $27K |
| Life insurance | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | 204 | $28K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 205 | $27K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 137 | $1.7M |
| Other | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | 204 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.