# FSA OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO CAMPUS DINING & SHOPS MEDICAL PLAN

Health and welfare plan sponsored by **FACULTY-STUDENT ASSOCIATION OF STATE UNIVERSITY OF** (dba NEW YORK AT BUFFALO, INC.). Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | FACULTY-STUDENT ASSOCIATION OF STATE UNIVERSITY OF |
| EIN | 166018833 |
| Plan number | 503 |
| Plan year | 2025 |
| Location | BUFFALO, NY |
| Industry | civic & social organization |
| Funding | mixed |
| Total premiums | $58K |
| Participants | 166 |
| Persons covered | 200 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| DELTA DENTAL OF CALIFORNIA | Dental |

## Brokers

| Broker | Placed with |
|---|---|
| AP BENEFIT ADVISORS, LLC | DELTA DENTAL OF NEW YORK |

## About this data

- Source: public Form 5500 filings from the U.S. Department of Labor (EBSA), rebuilt on each DOL release.
- Full page (charts, history, peer benchmarks, fees, contacts): https://planoptica.com/welfare/166018833-503
- Cite as: PlanOptica, https://planoptica.com/welfare/166018833-503
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