Form 5500 · Employee benefit plan · ALBANY, NY
NEW YORK STATE BAR ASSOCIATION
The filing calls this plan NEW YORK STATE BAR ASSOCIATION SUPPLEMENTAL HEALTH CARE PLAN.
NEW YORK STATE BAR ASSOCIATION of ALBANY, NY is a small other services employer whose insured group plan is on public record in its Form 5500 filing. Its broker of record is KRISTA ANNE ROTONDI. Coverage is written through AFLAC. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 14-0923640 · plan 506 · plan year 2025, filed Jul 8, 2026
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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, health, through AFLAC, covering 23 people.
Reported premium across the insured contracts is $21,297, with $3,082 in disclosed broker commissions — about 14% 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.
At 23 participants this is a small group; Form 5500 is required once a welfare plan reaches 100 participants, or when it is funded through insurance contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AFLAC | Health | 23 | Jan 1, 2026 | $21,297 | $3,082 |
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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