Form 5500 · Employee benefit plan · NEW YORK CITY, NY
BD OF TR DERRICKMENS WELFARE FUND, LOCAL 197
BD OF TR DERRICKMENS WELFARE FUND, LOCAL 197 of NEW YORK CITY, NY files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is TOM DUSI. Coverage is written through EMPIRE HEALTHCHOICE ASSURANCE, INC. and 3 other carriers. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 13-6121369 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. | Health | 80 | October | $57,372 |
| ANTHEM LIFE & DISABILITY INSURANCE COMPANY | Life | 101 | January | $478 |
| THE UNION LABOR LIFE INSURANCE COMPANY | Life | 151 | June | $0 |
| THE UNION LABOR LIFE INSURANCE COMPANY | — | 55 | December | $0 |
Questions
Who is BD OF TR DERRICKMENS WELFARE FUND, LOCAL 197's benefits broker?
Per its most recent Form 5500 Schedule A, BD OF TR DERRICKMENS WELFARE FUND, LOCAL 197's broker of record is TOM DUSI.
What insurance carrier does BD OF TR DERRICKMENS WELFARE FUND, LOCAL 197 use?
BD OF TR DERRICKMENS WELFARE FUND, LOCAL 197's benefit plan is written through EMPIRE HEALTHCHOICE ASSURANCE, INC., among 4 disclosed carriers.
When does BD OF TR DERRICKMENS WELFARE FUND, LOCAL 197's group plan renew?
The most recent Schedule A policy period for BD OF TR DERRICKMENS WELFARE FUND, LOCAL 197 ended in October. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from BD OF TR DERRICKMENS WELFARE FUND, LOCAL 197's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.