Form 5500 · Employee benefit plan · GOUVERNEUR, NY
EMPIRE STATE MINES, LLC
EMPIRE STATE MINES, LLC's employee benefit plan is documented in its annual Form 5500 filing with the Department of Labor. Its broker of record is BURNHAM FINANCIAL SERVICES. Coverage is written through EXCELLUS BLUE CROSS BLUE SHIELD and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 83-0361818 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 129 | December | $84,117 |
| GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision | 163 | December | $11,113 |
| ANTHEM LIFE AND DISABILITY INS CO | — | 165 | December | $4,215 |
Questions
Who is EMPIRE STATE MINES, LLC's benefits broker?
Per its most recent Form 5500 Schedule A, EMPIRE STATE MINES, LLC's broker of record is BURNHAM FINANCIAL SERVICES.
What insurance carrier does EMPIRE STATE MINES, LLC use?
EMPIRE STATE MINES, LLC's benefit plan is written through EXCELLUS BLUE CROSS BLUE SHIELD, among 3 disclosed carriers.
When does EMPIRE STATE MINES, LLC's group plan renew?
The most recent Schedule A policy period for EMPIRE STATE MINES, LLC ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from EMPIRE STATE MINES, LLC's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.