| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | EXCELLUS BLUECROSS BLUESHIELD | $9K | — | $9K | 5.00% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $1K | $12K | 13.51% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $4K | $2K | $6K | 18.01% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $1K | $1K | 4.44% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $979 | — | $979 | 9.75% |
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 | 261 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 7 | $73K |
| Dental(2 contracts, 2 carriers) | EXCELLUS BLUECROSS BLUESHIELD | 228 | $248K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 148 | $83K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 261 | $90K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 262 | $32K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 7 | $73K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 261 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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.