| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT RELPH AGENCY | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | MVP HEALTH CARE | $81K | — | $81K | 4.19% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $8K | — | $8K | 5.35% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY | 400 WILLOWBROOK STE 400 WILLOWBROOK OFFICE PARK FAIRPORT, NY 14450 | CIGNA LIFE INSURANCE CO OF NY | $3K | — | $3K | 6.32% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | — | CIGNA LIFE INSURANCE CO OF NY | — | $2K | $2K | 4.83% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT RELPH AGENCY | 400 WILLOWBROOK STE 400 WILLOWBROOK OFFICE PARK FAIRPORT, NY 14450 | CIGNA LIFE INSURANCE CO OF NY | $3K | — | $3K | 13.27% |
| BAN3 | — | CIGNA LIFE INSURANCE CO OF NY | — | $912 | $912 | 3.98% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT RELPH AGENCY | 400 WILLOWBROOK OFFICE PARK SUITE 40 FAIRPORT, NY 14450 | GUARDIAN LIFE INSURANCE CO OF AMERICA | $2K | $1K | $3K | 15.51% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 NORTH MARKET ST SUITE 1300 WILMINGTON, DE 19801 | GUARDIAN LIFE INSURANCE CO OF AMERICA | $24 | — | $24 | 0.13% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT RELPH AGENCY | 400 WILLOWBROOK STE 400 WILLOWBROOK OFFICE PARK FAIRPORT, NY 14450 | CIGNA LIFE INSURANCE CO OF NY | $470 | — | $470 | 15.01% |
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 | 267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTH CARE | 333 | $1.9M |
| Dental | EXCELLUS BLUECROSS BLUESHIELD | 215 | $158K |
| Vision | GUARDIAN LIFE INSURANCE CO OF AMERICA | 162 | $18K |
| Life insurance | CIGNA LIFE INSURANCE CO OF NY | 267 | $40K |
| Long-term disability | CIGNA LIFE INSURANCE CO OF NY | 233 | $23K |
| Prescription drug | MVP HEALTH CARE | 333 | $1.9M |
| Other(2 contracts, 2 carriers) | EMPLOYEE NETWORK, INC | 297 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 333 | — |
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.