| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $46K | — | $46K | 3.76% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON | 231 SALINA MEADOWS SYRACUSE, NY 13212 | EXCELLUS BLUECROSS BLUESHIELD | $5K | — | $5K | 0.37% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 3.76% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON INC | 231 SALINA MEADOWS SYRACUSE, NY 13221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 1.23% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | $4K | — | $4K | 6.71% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON INC | 231 SALINA MEADOWS SYRACUSE, NY 13212 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | $784 | — | $784 | 1.29% |
| MGIS3 | 10 WEST BROADWAY SUITE 800 SALT LAKE CITY, UT 84101 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | — | $180 | $180 | 0.30% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | SUN LIFE INSURANCE & ANNUITY COMPANY OF NEW YORK | $3K | — | $3K | 6.69% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON INC | 231 SALINA MEADOWS SYRACUSE, NY 13212 | SUN LIFE INSURANCE & ANNUITY COMPANY OF NEW YORK | $558 | — | $558 | 1.31% |
| MIGIS3 | 10 WEST BROADWAY SUITE 800 SALT LAKE, UT 84101 | SUN LIFE INSURANCE & ANNUITY COMPANY OF NEW YORK | — | $180 | $180 | 0.42% |
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 | 268 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 178 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 268 | $289K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 268 | $289K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 268 | $289K |
| Short-term disability | SUN LIFE INSURANCE & ANNUITY COMPANY OF NEW YORK | 135 | $43K |
| Long-term disability | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | 129 | $61K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 268 | $289K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.