| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HR BENEFIT ADVISORS3 | 74 BROWNS RACE SUITE 200 ROCHESTER, NY 14614 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $940 | — | $940 | 5.19% |
| RELPH ROBERT G AGENCY INC3 Filed as: RELPH ROBERT G. AGENCY | 800 PARKER HILL DRIVE, SUITE 100 ROCHESTER, NY 14625 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $577 | — | $577 | 3.19% |
| ALLIANCE ADVISORY RP INC.3 | 350 ESSJAY ROAD WILLIAMSVILLE, NY 14221 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19 | — | $19 | 0.10% |
| ALLIANCE ADVISORY GRP INC3 Filed as: ALLIANCE ADVISORY GRP INC. | 600 DELAWARE AVENUE BUFFALO, NY 14202 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12 | — | $12 | 0.07% |
| HR BENEFIT ADVISORS3 | 400 WILLOWBROOKE OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $570 | — | $570 | 11.01% |
| HR BENEFIT ADVISORS3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $200 | — | $200 | 14.99% |
| HR BENEFIT ADVISORS3 Filed as: HR BENEFIT ADVISORS LTD | 74 BROWNS RACE, SUITE 200 ROCHESTER, NY 14614 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $84 | — | $84 | 10.97% |
| HR BENEFIT ADVISORS3 Filed as: HR BENEFIT ADVISORS LTD | 74 BROWNS RACE, SUITE 200 ROCHESTER, NY 14614 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $52 | — | $52 | 14.86% |
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 | 234 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENT HEALTH | 39 | $193K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 38 | $18K |
| Life insurance(2 contracts, 2 carriers) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 234 | $6K |
| Long-term disability(2 contracts, 2 carriers) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 30 | $2K |
| Prescription drug | INDEPENDENT HEALTH | 39 | $193K |
| Other(2 contracts, 2 carriers) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 234 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.