| 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 | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 10.73% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $4K | — | $4K | 15.00% |
| 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 | $2K | $2K | $4K | 16.08% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $88 | $3K | 13.93% |
| 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 | $550 | $294 | $844 | 15.34% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | COMPANION LIFE INSURANCE COMPANY | — | $196 | $196 | 3.56% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFETIME BENEFIT SOLUTIONS EIN 16-1171765 THIRD PARTY ADMINISTRATOR | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $10K |
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 | 333 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 333 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIVERA HEALTHCARE | 225 | $2.5M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $22K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 333 | $102K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 87 | $23K |
| Long-term disability | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 333 | $96K |
| Prescription drug | UNIVERA HEALTHCARE | 225 | $2.5M |
| Other | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 333 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 333 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.