| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 6300 BRIDGEPOINT PKWY BLDG 3 SUITE 500 AUSTIN, TX 78730 | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 6.43% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | SUITE 500 3 PARKWAY N DEERFIELD, IL 60015 | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 4.86% |
| 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 | $6K | — | $6K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK E DRIVE STE 350 BEACHWOOD, OH 44122 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $80 | $80 | 0.19% |
| 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 | $4K | $312 | $4K | 12.42% |
| 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 | 7.80% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY N STE 500 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 4.52% |
| 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 | $251 | $145 | $396 | 15.78% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DRIVE STE 350 BEACHWOOD, OH 44122 | COMPANION LIFE INSURANCE COMPANY | — | $97 | $97 | 3.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNIVERA HEALTHCARE EIN 15-0329043 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | — | $12K |
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 | 383 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIVERA HEALTHCARE | 258 | $2.3M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 255 | $27K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 383 | $122K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 139 | $41K |
| Long-term disability | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 383 | $120K |
| Prescription drug | UNIVERA HEALTHCARE | 258 | $2.3M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 383 | $153K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 383 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.