| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | $56K | — | $56K | 4.02% |
| RELPH ROBERT G AGENCY INC3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 6.54% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 4.47% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY | 400 WILLOWBROOK OFFICE PK SUITE 400 FAIRPORT, NY 14450 | VISION SERVICE PLAN | $2K | — | $2K | 4.23% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $302 | — | $302 | 10.00% |
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 | 136 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EXCELLUS BLUECROSS BLUESHIELD | 109 | $1.4M |
| Dental | DELTA DENTAL OF WISCONSIN | 125 | $139K |
| Vision | VISION SERVICE PLAN | 126 | $37K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 136 | $146K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 136 | $146K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 136 | $146K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 109 | $1.4M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 136 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.