| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT RELPH AGENCY | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | UNIVERA HEALTHCARE | $80K | — | $80K | 5.98% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $199 | $3K | 18.32% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT J. RELPH AGENCY, INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 14.83% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $920 | $76 | $996 | 16.24% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $245 | $245 | 3.99% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | FIRST UNUM LIFE INSURANCE COMPANY | $854 | $74 | $928 | 16.30% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | FIRST UNUM LIFE INSURANCE COMPANY | $340 | $28 | $368 | 14.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMTON INC EIN 16-1554883 SELF-FUNDED DENTAL | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $10K |
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 | 231 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNIVERA HEALTHCARE | 155 | $1.3M |
| Vision | DAVIS VISION | 121 | $6K |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 231 | $26K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 26 | $6K |
| Long-term disability(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 19 | $8K |
| Prescription drug | UNIVERA HEALTHCARE | 155 | $1.3M |
| Other(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 231 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.