| 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 | EXCELLUS BLUE CROSS BLUE SHIELD | $65K | — | $65K | 3.83% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $7K | — | $7K | 6.95% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | COMPANION LIFE INSURANCE COMPANY | $4K | $862 | $5K | 17.98% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | COMPANION LIFE INSURANCE COMPANY | — | $739 | $739 | 2.56% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | $605 | $3K | 17.16% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $518 | $518 | 2.74% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | EYEMED VISION CARE | $1K | — | $1K | 9.96% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | COMPANION LIFE INSURANCE COMPANY | $1K | $421 | $2K | 13.37% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | COMPANION LIFE INSURANCE COMPANY | — | $361 | $361 | 2.89% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $740 | — | $740 | 9.85% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $409 | $138 | $547 | 13.37% |
| NATIONAL BENEFIT CENTER3 | ATTN DENISE SEFANOFF 23825 COMMERCE PARK BEACHWOOD, OH 44122 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $119 | $119 | 2.91% |
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 | 200 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 126 | $1.7M |
| Dental | EXCELLUS BLUE CROSS BLUE SHIELD | 117 | $107K |
| Vision | EYEMED VISION CARE | 208 | $14K |
| Life insurance(2 contracts) | COMPANION LIFE INSURANCE COMPANY | 200 | $41K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 160 | $19K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 126 | $1.7M |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 172 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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.