Form 5500 · Employee benefit plan · ROCHESTER, NY
JOINT BOARD OF TRUSTEES BRICKLAYERS &
The filing calls this plan BRICKLAYERS & ALLIED CRAFTWORKERS LOCAL 3 NY ROCHESTER CHAPTER WELFARE FUND.
JOINT BOARD OF TRUSTEES BRICKLAYERS & of ROCHESTER, NY insures health, vision and life coverage for its employees, per Schedule A of its Form 5500. Its broker of record is BROWN & BROWN OF NEW YORK, INC.. Coverage is written through EXCELLUS BLUE CROSS BLUE SHIELD and 3 other carriers. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 16-0983640 · plan 501 · plan year 2025, filed Apr 2, 2026
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171 other employer plans in New York have policy years ending in September. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Both, as reported
The filing reports both insurance premium and benefits paid from the plan's own money, and the two amounts do not line up.
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
Also declared: supplemental unemployment, scholarship, 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, vision and life; the largest, with EXCELLUS BLUE CROSS BLUE SHIELD, covers 335 people.
The filing declares health, vision, life, dental and disability. Dental and disability 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 $3,612,116, with $103,536 in disclosed broker commissions — about 2.9% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
BROWN & BROWN OF NEW YORK, INC. is the broker of record on 4 of the 6 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 335 | Oct 1, 2025 | $3,446,604 | $93,590 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Vision | 175 | Oct 1, 2025 | $24,616 | $3,347 |
| MVP HEALTHCARE | Health | 19 | Oct 1, 2025 | $73,381 | $2,888 |
| METROPOLITAN LIFE INSURANCE COMPANY | Life | 331 | Oct 1, 2025 | $37,481 | $2,473 |
| MVP HEALTHCARE | Health | 5 | Oct 1, 2025 | $15,324 | $750 |
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 1 | Oct 1, 2025 | $14,710 | $488 |
Premium and claims on this contract
EXCELLUS BLUE CROSS BLUE SHIELD, contract 00009839. For the contract year on this filing, the carrier reported $3,446,604 in premium earned and $2,999,589 in claims incurred. Dividing one by the other gives 87%.
- EXCELLUS BLUE CROSS BLUE SHIELD, contract 00009839 reported $1,230,688 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. The service providers are named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
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