| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $75K | — | $75K | 3.46% |
| RELPH ROBERT G AGENCY INC3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $8K | $13K | 9.69% |
| RELPH ROBERT G AGENCY INC3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $2K | $7K | 16.42% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $714 | — | $714 | 1.68% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $189 | $3K | 16.05% |
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 | 293 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 165 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 227 | $138K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 227 | $138K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 293 | $42K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 53 | $22K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 165 | $2.2M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 293 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.