Form 5500 · Employee benefit plan · BOHEMIA, NY
NYSARC, INC. - SUFFOLK CHAPTER
The filing calls this plan NYSARC, INC. SUFFOLK CHAPTER GROUP WELFARE PLAN.
NYSARC, INC. - SUFFOLK CHAPTER of BOHEMIA, NY files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is JENNIFER SARAH TEPPER. Coverage is written through NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 11-1845294 · plan 501 · plan year 2026, filed Jul 9, 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
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
Health: CIGNA HEALTH AND LIFE INSURANCE COMPANY covers 54 of 748 participants (7.2%) on Schedule A.
Dental: CIGNA HEALTH AND LIFE INSURANCE COMPANY covers 54 of 748 participants (7.2%) on Schedule A.
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
Also declared: death benefits.
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 4 insured contracts covering health, dental, life and disability; the largest, with NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK, covers 650 people.
The filing declares health, dental, life, disability and vision. Vision appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
Reported premium across the insured contracts is $459,219, with $45,015 in disclosed broker commissions — about 9.8% 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.
JENNIFER SARAH TEPPER is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AFLAC | — | 119 | Feb 1, 2026 | $128,394 | $30,343 |
| NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | Life, Disability | 650 | Jan 1, 2026 | $263,695 | $12,764 |
| FIRST UNUM LIFE INSURANCE COMPANY | Disability | 101 | Jan 1, 2026 | $52,006 | $1,908 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental | 54 | Jan 1, 2026 | $15,124 | $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. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 864 employees, 52 recordable cases, 183 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
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Renewal calendar
3,536 other employer plans in New York are January 1 renewals (policy year ends December).
Their policy years end in December, like this plan’s, so most renew January 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
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