Filings through .
History & trajectory Charts need 2 or more years. This plan has 4 years on file; Pro shows them all.
See pricingThe top carrier holds over 85% of premium. A rate increase from that carrier moves the whole plan.
Schedule A insurance contracts: who carries the risk, for which benefits, and how many people they cover.
| Carrier | Coverage | Premium, renewal |
|---|---|---|
Broker: Robert G Relph Agency, Inc HealthRx | HealthRx | Available on Pro |
Broker: Robert G Relph Agency, Inc DentalVision | DentalVision | Available on Pro |
Broker: Robert G Relph Agency Inc LTDOther | LTDOther | Available on Pro |
Broker: Robert G Relph Agency Inc Life | Life | Available on Pro |
Broker: Robert G Relph Agency Inc LifeOther | LifeOther | Available on Pro |
See premium, retention and renewal dates for 6 contracts with Pro. Pro shows premium, covered lives, retention, contract numbers and the renewal date for each contract. Free for 7 days, then $49 a month.
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."
Brokers paid through Schedule A and service providers paid through Schedule C.
| Broker | Commissions, fees |
|---|---|
Carrier: Excellus Blue Cross Blue Shield | Available on Pro |
Carrier: The Guardian Life Insurance Company of America | Available on Pro |
Carrier: The Guardian Life Insurance Company of America | Available on Pro |
Carrier: Mutual of Omaha Insurance Company | Available on Pro |
Carrier: Mutual of Omaha Insurance Company | Available on Pro |
Carrier: Companion Life Insurance Company | Available on Pro |
Carrier: Companion Life Insurance Company | Available on Pro |
Carrier: First Unum Life Insurance Company | Available on Pro |
No Schedule C service providers reported on this filing.
How the health and benefits plan is funded and what that means for risk.
2 contacts
4 filings · 2019 to 2025