Form 5500 · Employee benefit plan · BUFFALO, NY
FACULTY-STUDENT ASSOCIATION OF STATE UNIVERSITY OF NEW YORK AT BUFFALO
The filing calls this plan FSA OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO CAMPUS DINING & SHOPS MEDICAL PLAN.
FACULTY-STUDENT ASSOCIATION OF STATE UNIVERSITY OF NEW YORK AT BUFFALO of BUFFALO, NY is a 137-participant other services employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is PREMIER CONSULTING ASSOCIATES. Coverage is written through METROPOLITAN LIFE INSURANCE COMPANY. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 16-6018833 · plan 503 · plan year 2024, filed Oct 14, 2025
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
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
The filing discloses a single insured line, dental, through METROPOLITAN LIFE INSURANCE COMPANY, covering 221 people.
The filing declares dental, health and vision. Health and vision appear with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $57,409, with $2,695 in disclosed broker commissions — about 4.7% of premium.
The most recent policy period ended in September, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY | Dental | 221 | Oct 1, 2024 | $57,409 | $2,695 |
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: 799 employees, 33 recordable cases, 823 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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