| 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 SUITE 100 ROCHESTER, NY 14625 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 4.82% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY NORTH STE 500 DEERFIELD, IL 60015 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 3.69% |
| IMG5 | 2960 N MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $106 | $106 | 0.05% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $7K | $3K | $10K | 21.00% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK, LLC | 23825 COMMERCE PARK STE A BEACHWOOD, OH 44122 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $117 | $117 | 0.26% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 24.30% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY NORTH STE 500 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $728 | $728 | 3.69% |
| ROBERT G. RELPH AGENCY, INC.3 | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 THIRD PARTY ADMIN | Claims processing Service code 12 | — | $168K |
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 | 549 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 549 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 254 | $20K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 334 | $19K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 549 | $235K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 92 | $45K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 549 | $235K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 549 | $235K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 549 | — |
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.