| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AFS AGENCY3 | 185 GENESEE STREET 2ND FL ADIRONDACK BANK BLDG UTICA, NY 13501 | EXCELLUS BLUECROSS BLUESHIELD | $6K | — | $6K | 3.37% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 7.70% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $92 | $92 | 0.09% |
| ADIRODACK FINANCIAL SERVICES DBA3 | AFS AGENCY 185 GENESEE STREET #210 UTICA, NY 13501 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $179 | $4K | 15.75% |
| AFS AGENCY3 | 185 GENESEE STREET SUITE 210 UTICA, NY 13501 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $396 | $3K | 22.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | — | $198K |
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 | 651 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 651 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 37 | $165K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $14K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 486 | $31K |
| Life insurance(2 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 651 | $128K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 651 | $104K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 651 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 651 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.