Form 5500 · Employee benefit plan · BROOKLYN, NY
EMPIRE MERCHANTS, LLC
The filing calls this plan EMPIRE MERCHANTS HEALTH & WELFARE BENEFITS PLAN FOR NON-BARGAINING EMPLOYEES.
EMPIRE MERCHANTS, LLC of BROOKLYN, NY files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is NFP CORPORATE SERVICES (NY) LLC. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-5431037 · plan 501 · plan year 2025, filed Jul 27, 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: other welfare.
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 CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 512 people.
Reported premium across the insured contracts is $2,110,055, with $97,516 in disclosed broker commissions — about 4.6% 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.
NFP CORPORATE SERVICES (NY) LLC is the broker of record on 1 of the 6 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including CIGNA HEALTH AND LIFE INSURANCE COMPANY, DELTA DENTAL OF NEW YORK, HARTFORD LIFE AND ACCIDENT and FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK. CIGNA HEALTH AND LIFE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health | 512 | Jan 1, 2026 | $1,525,783 | $78,642 |
| DELTA DENTAL OF NEW YORK | Dental | 506 | Jan 1, 2026 | $270,100 | $13,496 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | Vision | 257 | Jan 1, 2026 | $21,119 | $2,303 |
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 327 | Jan 1, 2026 | $269,337 | $1,502 |
| DELTA DENTAL OF NEW YORK | Dental | 90 | Jan 1, 2026 | $15,990 | $800 |
| ARAG INSURANCE COMPANY | — | 52 | Jan 1, 2026 | $7,726 | $773 |
Premium and claims on this contract
CIGNA HEALTH AND LIFE INSURANCE COMPANY, contract 3331653. For the contract year on this filing, the carrier reported $411,697 in premium earned and $329,139 in claims incurred. Dividing one by the other gives 80%.
- CIGNA HEALTH AND LIFE INSURANCE COMPANY, contract 3331653 reported $432,470 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.
Reported to OSHA
Reported to OSHA for 2025: 1,089 employees, 65 recordable cases, 2,018 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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