Form 5500 · Employee benefit plan · NEW HARTFORD, NY
UTICA MUTUAL INSURANCE COMPANY
The filing calls this plan UTICA MUTUAL INSURANCE COMPANY EMPLOYEE BENEFITS PLAN.
UTICA MUTUAL INSURANCE COMPANY of NEW HARTFORD, NY is a 1,458-participant finance and insurance employer — a large group whose insured benefits are disclosed on Schedule A of its Form 5500. Its broker of record is WILLIS TOWERS WATSON US LLC. Coverage is written through THE LINCOLN NATIONAL LIFE INSURANCE COMPANY and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 15-0476880 · plan 503 · plan year 2025, filed Aug 10, 2026
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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
Health: the largest of the 3 insured health contracts, with BLUE CROSS BLUE SHIELD, covers 80 of 1,458 participants (5.5%) on Schedule A.
2 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
Also declared: prepaid legal, severance, death benefits, other welfare.
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 8 insured contracts covering health, vision, life and disability; the largest, with THE LINCOLN NATIONAL LIFE INSURANCE COMPANY, covers 1,294 people.
The filing declares health, vision, life, disability and dental. Dental appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on one of the 2 contracts here that do not say what they cover.
Reported premium across the insured contracts is $2,388,171, with $145,770 in disclosed broker commissions — about 6.1% 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.
WILLIS TOWERS WATSON US LLC is the broker of record on 5 of the 8 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD | Health | 80 | Jan 1, 2026 | $689,406 | $41,316 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 1,294 | Jan 1, 2026 | $720,441 | $33,038 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Vision | 1,029 | Jan 1, 2026 | $250,481 | $26,854 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 707 | Jan 1, 2026 | $490,336 | $22,525 |
| METROPOLITAN LIFE INSURANCE COMPANY | Health | 650 | Jan 1, 2026 | $129,601 | $10,095 |
| METROPOLITAN LIFE INSURANCE COMPANY | Health | 1,016 | Jan 1, 2026 | $58,363 | $7,237 |
| METROPOLITAN GENERAL INSURANCE COMPANY | — | 275 | Jan 1, 2026 | $48,543 | $4,705 |
| ZURICH AMERICAN INSURANCE COMPANY | — | 1,345 | Jan 1, 2026 | $1,000 | $0 |
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
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