Form 5500 · Employee benefit plan · WEBSTER, NY
UR MEDICINE HOME CARE, INC
The filing calls this plan UR MEDICINE HOME CARE, INC HEALTH PLAN.
UR MEDICINE HOME CARE, INC of WEBSTER, NY files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is SMOLA CONSULTING. Coverage is written through EXCELLUS BLUE CROSS BLUE SHIELD. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 16-0743215 · plan 503 · plan year 2023, filed Oct 3, 2024
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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
All 4 insured contracts are health coverage with EXCELLUS BLUE CROSS BLUE SHIELD.
Reported premium across the insured contracts is $3,404,342, with $135,642 in disclosed broker commissions — about 4% 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.
SMOLA CONSULTING is the broker of record on all 4 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 173 | Jan 1, 2024 | $2,495,571 | $99,215 |
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 71 | Jan 1, 2024 | $812,407 | $32,572 |
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 7 | Jan 1, 2024 | $77,348 | $3,094 |
| EXCELLUS BLUE CROSS BLUE SHIELD | Health | 2 | Jan 1, 2024 | $19,016 | $761 |
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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