Form 5500 · Employee benefit plan · BROOKLYN, NY
EXCELSIOR CARE GRP LLC
The filing calls this plan EXCELSIOR CARE GRP WELFARE BENEFIT PLAN.
EXCELSIOR CARE GRP LLC of BROOKLYN, NY spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is GUTMAN INS AGENCY USA LLC. Coverage is written through SUN LIFE AND HEALTH INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in August.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 47-1358100 · plan 501 · plan year 2025, filed Mar 17, 2026
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124 other employer plans in New York have policy years ending in August. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Self-funded as reported
The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
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.
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 3 insured contracts covering health, dental, vision and stop-loss; the largest, with SUN LIFE AND HEALTH INSURANCE COMPANY, covers 464 people.
The medical plan carries stop-loss coverage: the filing reports the plan paying its own health claims, with insured protection against large ones.
Reported premium across the insured contracts is $1,001,275, with $139,621 in disclosed broker commissions — about 14% of premium.
The health contract's policy period ended in August, while at least one ancillary line's policy period ended in July. The plan is on a split renewal cycle.
GUTMAN INS AGENCY USA LLC is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE AND HEALTH INSURANCE COMPANY | Stop-loss | 464 | Aug 1, 2025 | $832,157 | $123,701 |
| PRINCIPAL LIFE INSURANCE COMPANY | Health, Dental | 281 | Sep 1, 2024 | $146,135 | $14,675 |
| VISION SERVICE PLAN | Vision | 151 | Aug 1, 2025 | $22,983 | $1,245 |
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
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Renewal calendar
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