| 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 STE 100 ROCHESTER, NY 14625 | SYMETRA LIFE INSURANCE COMPANY | $58K | $15K | $73K | 12.42% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | GUARDIAN LIFE INSURANCE COMPANY | $6K | — | $6K | 22.91% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY N STE 500 DEERFIELD, IL 60015 | GUARDIAN LIFE INSURANCE COMPANY | — | $450 | $450 | 1.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INDEPENDENT HEALTH EIN 16-1237733 SERVICE PROVIDER | Claims processing Service code 12 | — | $213K |
| RELPH BENEFIT ADVISORS EIN 16-1181862 CONSULTANT | Consulting (general) Service code 16 | — | $40K |
| GUARDIAN EIN 13-5123390 CLAIMS ADMIN | Claims processing Service code 12 | — | $19K |
| LIVINTI EIN 47-4999303 PBM | Claims processing Service code 12 | — | $7K |
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 | 566 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 566 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 321 | $24K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY | 321 | $24K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 566 | $585K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 566 | $585K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 566 | $585K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY | 287 | $397K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 566 | $585K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 566 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.