Form 5500 · Employee benefit plan · SYRACUSE, NY
STANDARD INSULATING CO.
The filing calls this plan STANDARD INSULATING CO INC.
STANDARD INSULATING CO. of SYRACUSE, NY spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is ONE GROUP NY INC. Coverage is written through EXCELLUS BLUE CROSS BLUE SHIELD and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 16-1418966 · plan 501 · plan year 2025, filed Aug 6, 2026
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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.
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
Schedule A lists 4 insured contracts covering health, dental, vision, life and disability; the largest, with EXCELLUS BLUE CROSS BLUE SHIELD, covers 37 people.
Reported premium across the insured contracts is $586,056, with $37,211 in disclosed broker commissions — about 6.3% 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.
ONE GROUP NY INC is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including EXCELLUS BLUE CROSS BLUE SHIELD, NORTHWESTERN MUTUAL and THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA. EXCELLUS BLUE CROSS BLUE SHIELD writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD | Health, Dental | 37 | Jan 1, 2026 | $508,161 | $27,140 |
| NORTHWESTERN MUTUAL | Disability | 38 | Jan 1, 2026 | $27,173 | $4,090 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision | 39 | Jan 1, 2026 | $26,747 | $3,655 |
| NORTHWESTERN MUTUAL | Life | 79 | Jan 1, 2026 | $23,975 | $2,326 |
Premium and claims on these contracts
NORTHWESTERN MUTUAL, contract 701921. For the contract year on this filing, the carrier reported $26,182 in premium earned and $-1,960 in claims incurred. Dividing one by the other gives -7%.
NORTHWESTERN MUTUAL, contract 701921. For the contract year on this filing, the carrier reported $23,189 in premium earned and $-895 in claims incurred. Dividing one by the other gives -4%.
- NORTHWESTERN MUTUAL, contract 701921 reported $28,142 in retention.
- NORTHWESTERN MUTUAL, contract 701921 reported $24,083 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.
Reported to OSHA
Reported to OSHA for 2025: 87 employees, 10 recordable cases, 2 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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