Form 5500 · Employee benefit plan · BUFFALO, NY
NOT FOR PROFIT INSURANCE CONSORTIUM
NOT FOR PROFIT INSURANCE CONSORTIUM of BUFFALO, NY is a 852-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Coverage is written through UNIVERA HEALTHCARE. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-6661156 · plan 501 · plan year 2023, filed Oct 15, 2024
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How this plan is funded
Fully insured as reported
The plan's own financial statement reports paying insurance carriers about what the insurance contracts report in premium.
The filing says this plan is subject to the Form M-1 requirement for multiple-employer welfare arrangements.
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.
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
All 3 insured contracts are health coverage with UNIVERA HEALTHCARE.
Reported premium is $6,717,491; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNIVERA HEALTHCARE | Health | 508 | Jan 1, 2024 | $5,166,083 | $0 |
| UNIVERA HEALTHCARE | Health | 158 | Jan 1, 2024 | $1,112,883 | $0 |
| UNIVERA HEALTHCARE | Health | 44 | Jan 1, 2024 | $438,525 | $0 |
Premium and claims on these contracts
UNIVERA HEALTHCARE, contract 00130590. For the contract year on this filing, the carrier reported $5,166,083 in premium earned and $5,756,184 in claims incurred. Dividing one by the other gives 111%.
UNIVERA HEALTHCARE, contract 00130591. For the contract year on this filing, the carrier reported $1,112,883 in premium earned and $1,885,376 in claims incurred. Dividing one by the other gives 169%.
- UNIVERA HEALTHCARE, contract 00130590 reported $945,818 in retention.
- UNIVERA HEALTHCARE, contract 00130591 reported $284,473 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.
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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