| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TITAN INS & EMPLOYEE BENEFITS3 Filed as: TITAN INS DBA US EMPL BENEFITS SVC | 1 SOUTH CLINTON AVE, SUITE 1090 ROCHESTER, NY 14604 | EXCELLUS BLUE CROSS SHIELD | $31K | — | $31K | 3.95% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DR. SUITE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS SHIELD | $0 | — | $0 | 0.00% |
| TITAN INS & EMPLOYEE BENEFITS3 | 1 S CLINTON AVE STE 1030 ROCHESTER, NY 14604 | MUTUAL OF OMAHA INSURANCE COMPANY | $985 | $191 | $1K | 11.94% |
| TITAN INSURANCE3 | ONE S.CLINTON AVE SUITE 1030 ROCHESTER, NY 14601 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $817 | — | $817 | 10.40% |
| TITAN INS & EMPLOYEE BENEFITS3 | 610 CLINTON SQ ROCHESTER, NY 14604 | MUTUAL OF OMAHA INSURANCE COMPANY | $729 | $140 | $869 | 11.93% |
| TITAN INS & EMPLOYEE BENEFITS3 | 1 S CLINTON AVE STE 1030 ROCHESTER, NY 14604 | COMPANION LIFE INSURANCE COMPANY | $377 | $75 | $452 | 11.98% |
| TITAN INS & EMPLOYEE BENEFITS3 | 1 S CLINTON AVE STE 1030 ROCHESTER, NY 14604 | MUTUAL OF OMAHA INSURANCE COMPANY | $108 | $21 | $129 | 11.97% |
| TITAN INS & EMPLOYEE BENEFITS3 | 1 S CLINTON AVE STE 1030 ROCHESTER, NY 14604 | MUTUAL OF OMAHA INSURANCE COMPANY | $46 | $12 | $58 | 12.64% |
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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS SHIELD | 81 | $773K |
| Dental | EXCELLUS BLUE CROSS SHIELD | 81 | $773K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 63 | $8K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 116 | $5K |
| Short-term disability(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 116 | $11K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 116 | $7K |
| Prescription drug | EXCELLUS BLUE CROSS SHIELD | 81 | $773K |
| Other(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 32 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 116 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.