| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 965 GREENTREE RD STE 310 PITTSBURGH, PA 15220 | AETNA LIFE INSURANCE CO. | — | $21K | $21K | 3.94% |
| ROBERT G. RELPH AGENCY, INC.3 | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $279 | $279 | 0.48% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $91 | $91 | 0.49% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $71 | $71 | 0.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing Service code 12 | — | $305K |
| ROBERT G RELPH AGENCY INC | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $102K |
| MERITAIN HEALTH EIN 16-1264154 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | — | $63K |
| EMPIRE HEALTH CHOICE ASSURANCE INC | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing Service code 12 | — | $47K |
| CARELONRX, INC EIN 82-3062245 THIRD PARTY ADMINISTRATOR | Float revenue; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | -$41K |
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 | 527 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 527 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 245 | $533K |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC | 1,220 | $1.2M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 879 | $64K |
| Life insurance(2 contracts) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 527 | $71K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 166 | $19K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC | 1,220 | $1.2M |
| Other(2 contracts) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 527 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,220 | — |
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.