Form 5500 · Employee benefit plan · LATHAM, NY
NEW YORK STATE UNITED TEACHERS
The filing calls this plan NEW YORK STATE UNITED TEACHERS STAFF WELFARE PLAN.
Public Form 5500 records show how NEW YORK STATE UNITED TEACHERS of LATHAM, NY, a other services employer, structures its employee benefits. Its broker of record is THE SEGAL COMPANY(EASTERN STATES),. Coverage is written through ANTHEM BLUE CROSS BLUE SHIELD and 7 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 14-1584772 · plan 501 · plan year 2025, filed Mar 30, 2026
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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.
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: death benefits, 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 10 insured contracts covering health, dental, vision, life, disability and stop-loss; the largest, with ANTHEM BLUE CROSS BLUE SHIELD, covers 1,636 people.
The filing lists a stop-loss contract. On its own that does not settle whether the plan pays its own claims.
Reported premium across the insured contracts is $23,535,898, with $25,140 in disclosed broker commissions — about 0.1% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in January. The plan is on a split renewal cycle.
THE SEGAL COMPANY(EASTERN STATES), is the broker of record on 1 of the 10 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE AND HEALTH INSURANCE COMPANY | Stop-loss | 882 | Jan 1, 2025 | $1,331,495 | $25,140 |
| ANTHEM BLUE CROSS BLUE SHIELD | Health | 1,636 | Jan 1, 2025 | $9,802,070 | $0 |
| CVS PHARMACY, INC | Health | 1,712 | Jan 1, 2025 | $9,073,475 | $0 |
| CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | Health | 177 | Jan 1, 2025 | $1,684,827 | $0 |
| DELTA DENTAL OF NEW YORK | Dental | 1,922 | Jan 1, 2025 | $878,872 | $0 |
| FIRST UNUM LIFE INSURANCE COMPANY | Life | 392 | Jan 2, 2025 | $329,813 | $0 |
| DAVIS VISION | Vision | 3,759 | Jan 1, 2025 | $148,368 | $0 |
| SHELTERPOINT LIFE INSURANCE COMPANY | — | 410 | Jan 1, 2025 | $143,386 | $0 |
| FIRST UNUM LIFE INSURANCE COMPANY | Disability | 392 | Jan 2, 2025 | $131,148 | $0 |
| FIRST UNUM LIFE INSURANCE COMPANY | Life | 86 | Jan 2, 2025 | $12,444 | $0 |
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.
Other plans filed by this employer
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