| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | EXCELLUS BLUECROSS BLUESHIELD | $9K | — | $9K | 5.63% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 11.05% |
| ROBERT G. RELPH AGENCY, INC.3 | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $3K | $14K | 16.93% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $1K | — | $1K | 3.79% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $154 | $154 | 0.57% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $4K | $265 | $4K | 16.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $204 | $204 | 0.77% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $3K | $202 | $3K | 16.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $156 | $156 | 0.77% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY, INC | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | SUN LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 9.81% |
| ROBERT G. RELPH AGENCY, INC.3 | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $979 | — | $979 | 12.45% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | — | $63 | $63 | 0.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | — | $14K |
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 | 637 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 637 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MVP SELECT CARE | 455 | $222K |
| Dental | EXCELLUS BLUECROSS BLUESHIELD | 438 | $160K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 440 | $80K |
| Life insurance(3 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 685 | $155K |
| Short-term disability(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 440 | $118K |
| Long-term disability(2 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 637 | $116K |
| Other(4 contracts, 3 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 822 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 822 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.