Form 5500 · Employee benefit plan · ELMA, NY
SUBURBAN ADULT SERVICES, INC,
The filing calls this plan SUBURBAN ADULT SERVICES WELFARE PLAN.
SUBURBAN ADULT SERVICES, INC, of ELMA, NY insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is GALLAGHER BENEFIT SERVICES, INC.. Coverage is written through INDEPENDENT HEALTH and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 16-1115992 · plan 520 · plan year 2024, filed Oct 15, 2025
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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.
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 9 insured contracts covering health, dental, vision, life and disability.
Reported premium across the insured contracts is $5,090,631, with $117,611 in disclosed broker commissions — about 2.3% 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.
GALLAGHER BENEFIT SERVICES, INC. is the broker of record on 8 of the 9 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including INDEPENDENT HEALTH, FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY and THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA. INDEPENDENT HEALTH writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| INDEPENDENT HEALTH | Health, Dental, Vision | 351 | Jan 1, 2025 | $4,553,748 | $67,682 |
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 1,376 | Jan 1, 2025 | $304,551 | $17,794 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision | 498 | Jan 1, 2025 | $105,653 | $17,287 |
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 32 | Jan 1, 2025 | $20,092 | $4,018 |
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 43 | Jan 1, 2025 | $17,322 | $3,464 |
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | Life | 511 | Jan 1, 2025 | $55,206 | $3,135 |
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 63 | Jan 1, 2025 | $16,244 | $2,398 |
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | Life | 44 | Jan 1, 2025 | $16,781 | $1,678 |
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | — | 54 | Jan 1, 2025 | $1,034 | $155 |
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: 757 employees, 15 recordable cases, 596 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
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