| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NOVA HEALTHCARE ADMINISTRATORS, INC3 | 6400 MAIN STREET SUITE 210 WILLIAMSVILLE, NY 14221 | GREENWICH INSURANCE COMPANY | $22K | — | $22K | 5.50% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | SYMETRA LIFE INSURANCE COMPANY | $14K | $1K | $15K | 15.85% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | SUN LIFE AND HEALTH INSURANCE COMPANY | $3K | — | $3K | 7.08% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 12.83% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | EASTERN VISION SERVICE PLAN, INC | $332 | — | $332 | 1.18% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | SUN LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 9.37% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | HARTFORD LIFE AND ACCIDENT | $88 | — | $88 | 1.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INDEPENDENT HEALTH EIN 16-1237733 SERVICE PROVIDER | Claims processing Service code 12 | — | $123K |
| HR BENEFIT ADVISORS EIN 16-1455424 CONSULTANT | Consulting (pension) Service code 17 | — | $40K |
| DENTAL PAY PLUS, INC. DBA PRO BENEF EIN 16-1514371 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $19K |
| MEDTRAKRX EIN 36-4221427 PBM | Claims processing 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 | 463 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 463 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EASTERN VISION SERVICE PLAN, INC | 211 | $28K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 463 | $94K |
| Short-term disability(3 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE COMPANY | 487 | $60K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 246 | $35K |
| Stop-loss / reinsurancereinsurance | GREENWICH INSURANCE COMPANY | 363 | $398K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 463 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 487 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.