| 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 | UNITED CONCORDIA INSURANCE COMPANY | $11K | — | $11K | 2.70% |
| RELPH ROBERT G AGENCY INC3 Filed as: RELPH BENEFIT ADVISORS | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $10K | — | $10K | 5.00% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK, LLC | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 0.63% |
| RELPH ROBERT G AGENCY INC3 Filed as: RELPH BENEFIT ADVISORS | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK, LLC | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $610 | — | $610 | 0.63% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $910 | — | $910 | 5.00% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK, LLC | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $115 | — | $115 | 0.63% |
| C H ROBINSON & ASSOCIATES INC3 Filed as: C H ROBINSON & ASSOCIATES, INC. | 55 PORTER ALLEY MECHANICSBURG, PA 17050 | CONTINENTAL AMERICAN INSURANCE COMPANY | $283 | — | $283 | 2.14% |
| J D LUEDTKE INC3 Filed as: J D LUEDTKE, INC. | 313 FOURTH STREET HANOVER, PA 17331 | CONTINENTAL AMERICAN INSURANCE COMPANY | $276 | — | $276 | 2.09% |
| ANTHONY S ALMODOVAR3 | 3605 VARTAN WAY SUITE 304 HARRISBURG, PA 17110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $113 | — | $113 | 0.86% |
| MG BERGER INC3 Filed as: MG BERGER, INC. | 1020 NORTH DELAWARE AVENUE 4TH FLOOR PHILADELPHIA, PA 19125 | CONTINENTAL AMERICAN INSURANCE COMPANY | $57 | — | $57 | 0.43% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | CONTINENTAL AMERICAN INSURANCE COMPANY | $52 | — | $52 | 0.39% |
| DARREN D RIDDLE3 | 7850 AVONDALE TERRACE HARRISBURG, PA 17112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.05% |
| ANGELA MASSARELLI3 | 432 TUVIRA LANE CHERRY HILL, NJ 08003 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.05% |
| MARTIN E BYSTROM3 | 333 OVERLOOK LANE GULPH MILLS, PA 19428 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.05% |
| RYAN K GOLDBERG3 | 103-107 CHURCH STREET PHILADELPHIA, PA 19106 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.05% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS, COUNSELMAN, MICHAELS & | DOWNES, INC. 555 FAIRMOUNT AVENUE TOWSON, MD 21286 | ACE AMERICAN INSURANCE COMPANY | $980 | — | $980 | 22.20% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS, COUNSELMAN, MICHAELS & | DOWNES, INC. 555 FAIRMOUNT AVENUE TOWSON, MD 21286 | ACE AMERICAN INSURANCE COMPANY | $230 | — | $230 | 21.50% |
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 | 833 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 833 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 1,338 | $424K |
| Vision | VISION BENEFITS OF AMERICA | 579 | $71K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 833 | $202K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 833 | $97K |
| Other(5 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 930 | $239K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,338 | — |
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.