| 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 | EXCELLUS BLUE CROSS BLUE SHIELD | $43K | — | $43K | 4.21% |
| 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 | $4K | — | $4K | 4.87% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY NORTH BLVD STE 500 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 4.46% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | $2K | $4K | 15.86% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY NORTH BLVD STE 500 DEERFIELD, IL 60015 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $250 | $250 | 0.98% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | COMPANION LIFE INSURANCE COMPANY | $649 | $380 | $1K | 15.84% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY NORTH BLVD STE 500 DEERFIELD, IL 60015 | COMPANION LIFE INSURANCE COMPANY | — | $63 | $63 | 0.97% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | FIRST UNUM LIFE INSURANCE COMPANY | $710 | $83 | $793 | 16.75% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $74 | $43 | $117 | 15.85% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY NORTH BLVD STE 500 DEERFIELD, IL 60015 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $7 | $7 | 0.95% |
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 | 103 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 56 | $1.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 67 | $74K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 67 | $74K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 103 | $11K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 103 | $26K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 56 | $1.0M |
| Other(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 103 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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.