| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $27K | — | $27K | 4.45% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $4K | — | $4K | 10.90% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK STE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $787 | — | $787 | 10.01% |
| ALLIANCE ADVSIORY GRP INC3 | 600 DELAWARE AVENUE BUFFALO, NY 14202 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12 | — | $12 | 0.15% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $719 | $505 | $1K | 17.02% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER, LLC | 1105 N MARKET ST. SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $53 | — | $53 | 0.74% |
| ALLIANCE ADVISORY GRP INC3 Filed as: ALLIANCE ADVISORY GROUP, INC. | 350 ESSJAY RD WILLIAMSVILLE, NY 14221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14 | — | $14 | 0.19% |
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 | 123 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 74 | $597K |
| Dental | EXCELLUS BLUECROSS BLUESHIELD | 81 | $34K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 60 | $7K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $8K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 74 | $597K |
| Other | EMPLOYEE SERVICES, INC. | 123 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.