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Original filing (PDF)20251006133042NAL0009011826001
EXCELLUS HEALTH PLAN, INC.
Form 5500
FILING_RECEIVED
EXCELLUS RETIREMENT PLAN
Defined-benefit pension plan
Signals · 3
100% in single holdingNo recordkeeper disclosed8 service providers
Active participants
1,912
Accounts w/ balance
—
Plan assets (EOY)
$746.9M
Net assets (EOY)
$746.9M
How this plan invests
This plan
1 pooled trust
Schedule D
1 securities
funds · stocks · CUSIPs
Holdings are itemized directly on this plan's Schedule of Assets, below.
Plan health score (directional)
81
/ 100
Grade B
Above-average plan
Directional indicator computed from public Form 5500 data — compliance, concentration, cost, vendor stack and participation. Not a fiduciary tool.
Compliance & disclosures
100
Concentration risk
75
Total plan cost
65
Vendor stack
43
Participation health
100
Knocking points off
- Top holding "Program interest in the Blue Cross and Blue Shield National Retirement Trust, a 103-12 investment entity" is 100% of plan.
- 21 bps in Schedule C fees — 244% above peer band of 6 bps.
- No recordkeeper disclosed on Schedule C.
- Highly fragmented vendor stack (8 disclosed providers, 5 categories).
- Plan is frozen (1I) — no new benefit accrual.
Decision-maker contacts
CFO / Head of HR / Benefits Manager — verified email + LinkedIn for EXCELLUS HEALTH PLAN, INC..
Plan sponsor
Name
EXCELLUS HEALTH PLAN, INC.
EIN
15-0329043
Address
165 COURT STREET · ROCHESTER, NY · 14647
Phone
(585) 454-1700
Industry
Finance & Insurancesee all
Plan administrator
Name
NATIONAL EMPLOYEE BENEFITS COMMITTE
EIN
36-3025560
City
CHICAGO, IL
Phone
(800) 777-8865
Plan characteristics
Plan number
001
Plan year
2024
Plan year begin
2024-01-01
Tax period
2024-12-31
Filed
2025-10-06
Pension benefit codes
1A · Pay-related DB formula
1I · Frozen plan — no new benefit accrual
3H · Sponsor in controlled / affiliated group
Audit & trust (Schedule H)
Auditor
PLANTE & MORAN, PLLC
Trustee / custodian
—
Trustee phone
—
Service providers (Schedule C)
8 rowsAdvisor / Consultant
1| Name | EIN | Location | Relation | Direct comp | Indirect comp |
|---|---|---|---|---|---|
| AON CONSULTING | 22-2232264 | — | ACTURIAL | $47K | — |
Trustee
1| Name | EIN | Location | Relation | Direct comp | Indirect comp |
|---|---|---|---|---|---|
| NORTHERN TRUST CO | 36-1561860 | — | TRUSTEE | $213K | — |
TPA / Administrator
1| Name | EIN | Location | Relation | Direct comp | Indirect comp |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD ASSOCIATION | 13-5656874 | — | PLAN ADMIN | $336K | — |
Accountant / Auditor
2| Name | EIN | Location | Relation | Direct comp | Indirect comp |
|---|---|---|---|---|---|
| PLANTE & MORAN, PLLC | 33-1498605 | — | ACCOUNTING | $97K | — |
| GRANT THORNTON, LLP | 36-6055558 | — | ACCOUNTING | $10K | — |
Other
3| Name | EIN | Location | Relation | Direct comp | Indirect comp |
|---|---|---|---|---|---|
| MERCER INVESTMENT MANAGEMENT | 30-0282430 | — | INVESTMENT MGMT | $811K | — |
| BLOOMBERG FINANCE L.P. | 06-1818168 | — | OTHER INV FEES,EXPENSES | $18K | — |
| L&S VENTURES | 75-3238476 | — | CONSULTING | $10K | — |
Investments
1 pooled fund· $746.9M(100% of reported assets)
Rows tagged as a trust or pooled fund hold many underlying securities. Click one to drill into its own Schedule of Assets — where the individual funds, shares, and CUSIPs live.
| PI | Investment | Type | Shares / units | Cost | Current value | % of plan |
|---|---|---|---|---|---|---|
| NATIONAL RETIREMENT TRUST BLUE CROSS AND BLUE SHIELD ASSOC. · EIN 36-6041816 / PN 001 | 103-12 Investment Entity | — | $781.9M | $746.9M | 100.0% |
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