Form 5500 · Employee benefit plan · SYRACUSE, NY
TCGPLAYER, INC.
The filing calls this plan TCGPLAYER, INC WELFARE BENEFIT PLAN.
Public Form 5500 records show how TCGPLAYER, INC. of SYRACUSE, NY, a hospitality and food service employer, structures its employee benefits. Its broker of record is LUMITY, INC. Coverage is written through EXCELLUS BLUE CROSS BLUE SHIELD and 1 other carrier. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-4051120 · plan 501 · plan year 2023, filed Sep 3, 2024
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113 other employer plans in New York have policy years ending in July. 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
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.
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 2 insured contracts covering health, life and disability; the largest, with EXCELLUS BLUE CROSS BLUE SHIELD, covers 497 people.
The filing declares health, life, disability, dental and vision. Dental and vision appear with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $3,420,023, with $103,688 in disclosed broker commissions — about 3% of premium.
The most recent policy period ended in July, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
LUMITY, INC is the broker of record on all 2 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 497 | Aug 1, 2023 | $3,230,668 | $90,434 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 603 | Aug 1, 2023 | $189,355 | $13,254 |
Premium and claims on this contract
EXCELLUS BLUE CROSS BLUE SHIELD, contract 113378. For the contract year on this filing, the carrier reported $3,230,668 in premium earned and $2,490,673 in claims incurred. Dividing one by the other gives 77%.
- EXCELLUS BLUE CROSS BLUE SHIELD, contract 113378 reported $526,757 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.
Other plans filed by this employer
How this plan compares
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Renewal calendar
113 other employer plans in New York are August 1 renewals (policy year ends July).
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