Form 5500 · Employee benefit plan · ROCHESTER, NY
R J CHEVROLET
The filing calls this plan BOB JOHNSON CHEVROLET WELFARE BENEFIT PLAN.
R J CHEVROLET of ROCHESTER, NY is a 479-participant retail employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is ROBERT G RELPH AGENCY INC.. Coverage is written through MVP HEALTH SERVICES CORP and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 16-1170100 · plan 501 · plan year 2025, filed Jun 24, 2026
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3,536 other employer plans in New York have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 5 insured contracts covering health, dental, vision, life and disability; the largest, with MVP HEALTH SERVICES CORP, covers 840 people.
Reported premium across the insured contracts is $5,545,144, with $186,860 in disclosed broker commissions — about 3.4% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
ROBERT G RELPH AGENCY INC. is the broker of record on 4 of the 5 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including MVP HEALTH SERVICES CORP, EXCELLUS BLUE CROSS BLUE SHIELD, SUN LIFE AND HEALTH INSURANCE COMPANY and EYEMED VISION CARE. MVP HEALTH SERVICES CORP writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| MVP HEALTH SERVICES CORP | Health | 840 | Jan 1, 2026 | $4,666,840 | $141,461 |
| SUN LIFE AND HEALTH INSURANCE COMPANY | Life, Disability | 425 | Jan 1, 2026 | $409,734 | $26,946 |
| EXCELLUS BLUE CROSS BLUE SHIELD | Dental | 616 | Jan 1, 2026 | $418,246 | $13,557 |
| EYEMED VISION CARE | Vision | 938 | Jan 1, 2026 | $50,199 | $4,891 |
| EYEMED VISION CARE | Vision | 1 | Jan 1, 2026 | $125 | $5 |
Premium and claims on this contract
EXCELLUS BLUE CROSS BLUE SHIELD, contract 00101670. For the contract year on this filing, the carrier reported $418,246 in premium earned and $281,868 in claims incurred. Dividing one by the other gives 67%.
- EXCELLUS BLUE CROSS BLUE SHIELD, contract 00101670 reported $89,767 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Other plans filed by this employer
How this plan compares
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Renewal calendar
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