Form 5500 · Employee benefit plan · ROCHESTER, NY
INTELLIMETAL, INC.
The filing calls this plan INTELLIMETAL, INC. EMPLOYEE BENEFIT PLAN.
INTELLIMETAL, INC. of ROCHESTER, NY files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is HILB GROUP OF NEW YORK LLC. Coverage is written through AETNA LIFE INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 46-5157882 · plan 502 · plan year 2023, filed Jul 22, 2024
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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 AETNA LIFE INSURANCE COMPANY, covers 84 people.
Reported premium across the insured contracts is $632,521, with $29,955 in disclosed broker commissions — about 4.7% 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.
HILB GROUP OF NEW YORK LLC is the broker of record on 2 of the 6 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including AETNA LIFE INSURANCE COMPANY, LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK and EYEMED VISION CARE. AETNA LIFE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY | Health | 84 | Jan 1, 2024 | $559,260 | $22,216 |
| LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | Life | 96 | Jan 1, 2024 | $27,506 | $2,611 |
| LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | Disability | 28 | Jan 1, 2024 | $12,430 | $1,865 |
| LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | Dental | 24 | Jan 1, 2024 | $17,820 | $1,650 |
| LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | Disability | 30 | Jan 1, 2024 | $10,886 | $1,334 |
| EYEMED VISION CARE | Vision | 55 | Jan 1, 2024 | $4,619 | $279 |
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
How this plan compares
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