| 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 | $91K | — | $91K | 2.79% |
| 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 | $9K | — | $9K | 3.41% |
| 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 | $14K | $4K | $18K | 19.46% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $3K | $3K | 3.40% |
| 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 | $5K | $3K | $7K | 15.79% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | COMPANION LIFE INSURANCE COMPANY | — | $2K | $2K | 4.97% |
| 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 | $3K | $1K | $4K | 14.57% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $1K | $1K | 3.92% |
| 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 | $3K | $616 | $3K | 12.36% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $528 | $528 | 2.02% |
| 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 | $1K | $600 | $2K | 14.03% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | COMPANION LIFE INSURANCE COMPANY | — | $515 | $515 | 3.45% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 17.00% |
| 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 | $691 | $278 | $969 | 14.02% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $238 | $238 | 3.44% |
| 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 | $227 | $117 | $344 | 15.13% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $100 | $100 | 4.40% |
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 | 612 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 612 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 352 | $3.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 989 | $263K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 989 | $263K |
| Life insurance(2 contracts) | COMPANION LIFE INSURANCE COMPANY | 612 | $61K |
| Short-term disability(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 191 | $105K |
| Long-term disability(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 111 | $56K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 352 | $3.3M |
| Other(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 612 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 989 | — |
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.