Form 5500 · Employee benefit plan · FARMINGTON, NY
ULTRAFAB, INC.
ULTRAFAB, INC. of FARMINGTON, NY files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is PAYCHEX AGENCY, 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 16-0984733 · plan 530 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 181 | December | $78,724 |
| LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | Life, Disability | 268 | December | $17,348 |
| SUN LIFE AND HEALTH INSURANCE COMPANY | Dental, Vision | 176 | December | $6,724 |
Questions
Who is ULTRAFAB, INC.'s benefits broker?
Per its most recent Form 5500 Schedule A, ULTRAFAB, INC.'s broker of record is PAYCHEX AGENCY, INC..
What insurance carrier does ULTRAFAB, INC. use?
ULTRAFAB, INC.'s benefit plan is written through EXCELLUS BLUE CROSS BLUE SHIELD, among 3 disclosed carriers.
When does ULTRAFAB, INC.'s group plan renew?
The most recent Schedule A policy period for ULTRAFAB, INC. ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from ULTRAFAB, INC.'s public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.