| 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 BLUECROSS BLUESHIELD | $30K | — | $30K | 4.42% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | EXCELLUS BLUECROSS BLUESHIELD | $4K | — | $4K | 10.70% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | ESI EMPLOYEE ASSISTANCE GROUP | $287 | — | $287 | 5.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 Filed as: PLANSOURCE BEN ADMINISTRATION, INC | PO BOX 1313 ORLANDO, FL 32802 | COMPANION LIFE INSURANCE COMPANY | — | $828 | $828 | 17.13% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | COMPANION LIFE INSURANCE COMPANY | $483 | $161 | $644 | 13.33% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | COMPANION LIFE INSURANCE COMPANY | — | $138 | $138 | 2.86% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | COMPANION LIFE INSURANCE COMPANY | $371 | $113 | $484 | 13.06% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | COMPANION LIFE INSURANCE COMPANY | — | $97 | $97 | 2.62% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $67 | $22 | $89 | 13.24% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $19 | $19 | 2.83% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $48 | $13 | $61 | 12.84% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $11 | $11 | 2.32% |
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 | 131 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 78 | $676K |
| Dental | EXCELLUS BLUECROSS BLUESHIELD | 74 | $39K |
| Life insurance(2 contracts) | COMPANION LIFE INSURANCE COMPANY | 131 | $9K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 78 | $676K |
| Other(3 contracts, 2 carriers) | ESI EMPLOYEE ASSISTANCE GROUP | 178 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.