| 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 | MVP HEALTHCARE | $93K | — | $93K | 4.48% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 12.03% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $62 | $62 | 0.05% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $22 | $22 | 0.02% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $2K | $4K | 16.79% |
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 | 363 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTHCARE | 344 | $2.1M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 227 | $22K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 363 | $113K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 363 | $113K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 363 | $113K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 363 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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.