| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MVP HEALTHCARE | $71K | — | $71K | 3.41% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $3K | $1K | $4K | 10.05% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $146 | $3K | 17.75% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | EYEMED VISION CARE | $1K | — | $1K | 9.24% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | — |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY NORTH STE 500 DEERFIELD, IL 60015 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $302 | $302 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 SELF-FUNDED DENTAL | Claims processing Service code 12 | — | $17K |
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 | 273 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MVP HEALTHCARE | 200 | $2.1M |
| Vision | EYEMED VISION CARE | 154 | $16K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 273 | $61K |
| Long-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 271 | $0 |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 449 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 449 | — |
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.