# NYCHSRO/MED-REVIEW, INC. WELFARE BENEFITS PLAN

Health and welfare plan sponsored by **NY COUNTY HEALTH SERVICES REVIEW ORGANIZATION, INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | NY COUNTY HEALTH SERVICES REVIEW ORGANIZATION, INC. |
| EIN | 237379635 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | NEW YORK, NY |
| Industry | Professional, Scientific, and Technical Services |
| Funding | fully insured |
| Total premiums | $3.9M |
| Participants | 256 |
| Persons covered | 248 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, STD, LTD, Other |
| VISION SERVICE PLAN (VSP) | Vision |
| PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | Other |

## Brokers

| Broker | Placed with |
|---|---|
| GALLAGHER BENEFIT SERVICES, INC. | CIGNA HEALTH AND LIFE INSURANCE COMPANY |
| GALLEGHER BENEFIT SERVICES | FIRST UNUM LIFE INSURANCE COMPANY |
| GALLAGHER BENEFIT SERVICES, INC. | FIRST UNUM LIFE INSURANCE COMPANY |
| GALLAGHER BENEFIT SERVICES, INC. | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY |
| GALLAGHER BENEFIT SERVICES, INC. | VISION SERVICE PLAN |
| KIMBERLY N. HARDIN | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD |
| GALLAGHER BENEFIT SERVICES, INC. | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD |
| BROCK JOHNSON | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD |

## 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/237379635-501
- Cite as: PlanOptica, https://planoptica.com/welfare/237379635-501
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