Form 5500 · Employee benefit plan · VICTOR, NY
FIRST AMERICAN COMMERCIAL BANCORP, INC.
The filing calls this plan FIRST AMERICAN EQUIPMENT FINANCE.
FIRST AMERICAN COMMERCIAL BANCORP, INC. of VICTOR, NY spreads its employee benefits across 6 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is TITAN INS. DBA US EMPL BEN SERV GR. Coverage is written through EXCELLUS BLUE CROSS BLUE SHIELD and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 36-4014671 · plan 501 · plan year 2025, filed Jul 20, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
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: death benefits.
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 12 insured contracts covering health, dental, vision, life and disability; the largest, with EXCELLUS BLUE CROSS BLUE SHIELD, covers 202 people.
Reported premium across the insured contracts is $3,904,161, with $123,984 in disclosed broker commissions — about 3.2% 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.
TITAN INS. DBA US EMPL BEN SERV GR is the broker of record on 1 of the 12 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including EXCELLUS BLUE CROSS BLUE SHIELD, PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY, MUTUAL OF OMAHA INSURANCE COMPANY and EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. OF NY. 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 | 202 | Jan 1, 2026 | $3,484,255 | $94,749 |
| PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | Dental | 213 | Jan 1, 2026 | $183,755 | $8,976 |
| EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. OF NY | Vision | 154 | Jan 1, 2026 | $24,612 | $5,665 |
| MUTUAL OF OMAHA INSURANCE COMPANY | — | 299 | Jan 1, 2026 | $119,141 | $5,441 |
| MUTUAL OF OMAHA INSURANCE COMPANY | Disability | 299 | Jan 1, 2026 | $27,667 | $2,767 |
| COMPANION LIFE INSURANCE COMPANY | Life | 103 | Jan 1, 2026 | $22,763 | $2,276 |
| COMPANION LIFE INSURANCE COMPANY | Life | 299 | Jan 1, 2026 | $14,224 | $1,422 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | 36 | Jan 1, 2026 | $6,744 | $752 |
| MUTUAL OF OMAHA INSURANCE COMPANY | Life | 299 | Jan 1, 2026 | $6,756 | $676 |
| MUTUAL OF OMAHA INSURANCE COMPANY | — | 66 | Jan 1, 2026 | $5,326 | $533 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | 24 | Jan 1, 2026 | $4,688 | $513 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | 12 | Jan 1, 2026 | $4,230 | $214 |
Premium and claims on these contracts
EXCELLUS BLUE CROSS BLUE SHIELD, contract 101361. For the contract year on this filing, the carrier reported $3,484,255 in premium earned and $4,823,587 in claims incurred. Dividing one by the other gives 138%.
PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY, contract 00101514. For the contract year on this filing, the carrier reported $183,755 in premium earned and $171,505 in claims incurred. Dividing one by the other gives 93%.
- EXCELLUS BLUE CROSS BLUE SHIELD, contract 101361 reported $582,343 in retention.
- PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY, contract 00101514 reported $37,642 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.
How this plan compares
Subscribers see how this compares with similar plans in New York. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
Renewal calendar
3,536 other employer plans in New York are January 1 renewals (policy year ends December).
Their policy years end in December, like this plan’s, so most renew January 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
Claude & ChatGPT
Look up records from Claude or ChatGPT
Add Form5500Lookup to Claude or ChatGPT and ask about any employer, broker or carrier in plain English. Lookups are free. Renewal lists, full books of business and exports are included with a subscription.
Building a list or a tool from these records? Match a list you already have from $29 per 1,000 records, or license the whole dataset as a weekly file for $499 a month. See both
More employer plans in New York — largest plans, brokers, carriers and renewal months.