Form 5500 · Employee benefit plan · BINGHAMTON, NY
COLUMBIAN MUTUAL LIFE INSURANCE COMPANY
COLUMBIAN MUTUAL LIFE INSURANCE COMPANY of BINGHAMTON, NY insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is HAYLOR FREYER & COON. Coverage is written through EXCELLUS BLUE CROSS BLUE SHIELD and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 15-0274455 · plan 501 · plan year 2025, filed Jun 4, 2026
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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
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 6 insured contracts covering health, dental, vision, life and disability; the largest, with EXCELLUS BLUE CROSS BLUE SHIELD, covers 121 people.
Reported premium across the insured contracts is $2,680,220, with $95,045 in disclosed broker commissions — about 3.5% 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.
HAYLOR FREYER & COON is the broker of record on 4 of the 6 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including EXCELLUS BLUE CROSS BLUE SHIELD, THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, THE PAUL REVERE LIFE INSURANCE COMPANY and FIDELITY SECURITY LIFE INSURANCE COMPANY. EXCELLUS BLUE CROSS BLUE SHIELD writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 121 | Jan 1, 2026 | $2,321,235 | $77,324 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 160 | Jan 1, 2026 | $136,557 | $10,154 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental | 125 | Jan 1, 2026 | $136,724 | $4,051 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Disability | 160 | Jan 1, 2026 | $54,769 | $2,462 |
| THE PAUL REVERE LIFE INSURANCE COMPANY | Disability | 16 | Jan 1, 2026 | $16,937 | $1,054 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 196 | Jan 1, 2026 | $13,998 | $0 |
Premium and claims on this contract
EXCELLUS BLUE CROSS BLUE SHIELD, contract 00008489. For the contract year on this filing, the carrier reported $2,321,235 in premium earned and $2,160,439 in claims incurred. Dividing one by the other gives 93%.
- EXCELLUS BLUE CROSS BLUE SHIELD, contract 00008489 reported $329,168 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.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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