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  5. EXCELLUS HEALTH PLAN, INC.

EXCELLUS HEALTH PLAN, INC.

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Company Details

Name: EXCELLUS HEALTH PLAN, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 02 Jan 1936 (90 years ago)
Entity Number: 38007
ZIP code: 14647
County: Monroe
Place of Formation: New York
Address: 165 COURT STREET, ROCHESTER, NY, United States, 14647

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 165 COURT STREET, ROCHESTER, NY, United States, 14647

Unique Entity ID

Unique Entity ID:
V23MY7HELMA7
CAGE Code:
3PPP0
UEI Expiration Date:
2025-02-26

Business Information

URL:
http://www.excellusbcbs.com
Division Name:
EXCELLUS BLUECROSS BLUESHIELD
Activation Date:
2024-02-29
Initial Registration Date:
2004-01-14

Commercial and government entity program

CAGE number:
836D2
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2024-08-24
CAGE Expiration:
2024-08-23

Contact Information

POC:
JENNIFER SIMMONS

National Provider Identifier

NPI Number:
1942578935
Link:
View on NPI website

Authorized Person:

Name:
BRANDI BISHOP
Role:
DIRECTOR, NYS GOV'T PROGRAMS FINANC
Phone:
5852384554

Taxonomy:

Selected Taxonomy:
302R00000X - Health Maintenance Organization
Is Primary:
Yes

Contacts:

Phone:
+1 585-238-4554

Legal Entity Identifier

LEI Number:
254900XW4TFFU135LI22

Registration Details:

Initial Registration Date:
2020-07-07
Next Renewal Date:
2026-05-07
Registration Status:
ISSUED
Validation Source:
FULLY_CORROBORATED

Form 5500 Series

Employer Identification Number (EIN):
150329043
Plan Year:
2009
Number Of Participants:
5165
Sponsors Telephone Number:
5854541400
File:
View File
Plan Year:
2009
Number Of Participants:
5330
Sponsors Telephone Number:
5854541400
File:
View File
Plan Year:
2009
Number Of Participants:
376
Sponsors Telephone Number:
5854541400
File:
View File
Plan Year:
2009
Number Of Participants:
3850
Sponsors Telephone Number:
5854541400
File:
View File

History

Start date End date Type Value
1998-12-16 1999-08-10 Address GATEWAY CENTRE, 150 EAST MAIN STREET, ROCHESTER, NY, 14642, USA (Type of address: Service of Process)
1996-01-11 1998-12-16 Address 344 SOUTH WARREN STREET, SYRACUSE, NY, 13202, USA (Type of address: Service of Process)
1984-12-04 1996-01-11 Address 344 SOUTH WARREN ST, SYRACUSE, NY, 13202, USA (Type of address: Service of Process)
1984-12-04 1996-01-11 Name BLUE CROSS AND BLUE SHIELD OF CENTRAL NEW YORK, INC.
1973-08-15 1984-12-04 Address 407 S. STATE ST., SYRACUSE, NY, 13201, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
011001000185 2001-10-01 CERTIFICATE OF MERGER 2001-10-01
010102000253 2001-01-02 CERTIFICATE OF MERGER 2001-01-02
990810000129 1999-08-10 CERTIFICATE OF CHANGE 1999-08-10
981231000247 1998-12-31 CERTIFICATE OF AMENDMENT 1998-12-31
981216000682 1998-12-16 CERTIFICATE OF MERGER 1998-12-31

USAspending Awards / Contracts

Procurement Instrument Identifier:
6923G521P0034
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
43402.00
Base And Exercised Options Value:
43402.00
Base And All Options Value:
43402.00
Awarding Agency Name:
Department of Transportation
Performance Start Date:
2021-01-01
Description:
DENTAL INSURANCE-COLLECTIE BARGINING AGREEMENT.
Naics Code:
524114: DIRECT HEALTH AND MEDICAL INSURANCE CARRIERS
Product Or Service Code:
G008: SOCIAL- GOVERNMENT INSURANCE PROGRAMS: OTHER
Procurement Instrument Identifier:
6923G520P0036
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
-420.11
Base And Exercised Options Value:
-420.11
Base And All Options Value:
-420.11
Awarding Agency Name:
Department of Transportation
Performance Start Date:
2020-01-01
Description:
DENTAL INSURANCE
Naics Code:
524114: DIRECT HEALTH AND MEDICAL INSURANCE CARRIERS
Product Or Service Code:
G008: SOCIAL- GOVERNMENT INSURANCE PROGRAMS: OTHER
Procurement Instrument Identifier:
DTSL5515CC0391
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
DEFINITIVE CONTRACT
Action Obligation:
30000.00
Base And Exercised Options Value:
30000.00
Base And All Options Value:
150000.00
Awarding Agency Name:
Department of Transportation
Performance Start Date:
2015-01-01
Description:
IGF::OT::IGF DENTAL INSURANCE PLAN FOR APPROXIMATELY 80 SLSDC EMPLOYEES FOR CALENDAR YEAR 2015 WITH OPTIONS FOR AN ADDITIONAL 4 YEARS.
Naics Code:
524114: DIRECT HEALTH AND MEDICAL INSURANCE CARRIERS
Product Or Service Code:
G008: SOCIAL- GOVERNMENT INSURANCE PROGRAMS: OTHER

Trademarks Section

Serial Number:
98544464
Mark:
UNIVERA SENIORCHOICE DISCOVERY
Status:
ABANDONED - EXPRESS
Mark Type:
SERVICE MARK
Application Filing Date:
2024-05-10
Mark Drawing Type:
Standard character mark
Mark Literal Elements:
UNIVERA SENIORCHOICE DISCOVERY
USPTO Link:
View Trademark Status and Document Retrieval (TSDR)

Goods And Services

For:
Insurance services, namely, underwriting medicare PPO plan insurance
International Classes:
036 - Primary Class
Class Status:
Active
Serial Number:
97920280
Mark:
UNIVERA SENIORCHOICE BALANCE
Status:
ABANDONED - NO STATEMENT OF USE FILED
Mark Type:
SERVICE MARK
Application Filing Date:
2023-05-04
Mark Drawing Type:
Standard character mark
Mark Literal Elements:
UNIVERA SENIORCHOICE BALANCE
USPTO Link:
View Trademark Status and Document Retrieval (TSDR)

Goods And Services

For:
Insurance services, namely, underwriting medicare PPO plan insurance insurance
International Classes:
036 - Primary Class
Class Status:
Active
Serial Number:
97877387
Mark:
UNIVERA SENIORCHOICE COMPLETE
Status:
ABANDONED - NO STATEMENT OF USE FILED
Mark Type:
SERVICE MARK
Application Filing Date:
2023-04-07
Mark Drawing Type:
Standard character mark
Mark Literal Elements:
UNIVERA SENIORCHOICE COMPLETE
USPTO Link:
View Trademark Status and Document Retrieval (TSDR)

Goods And Services

For:
Insurance services, namely, underwriting medicare PPO plan insurance
International Classes:
036 - Primary Class
Class Status:
Active
Serial Number:
97590541
Mark:
EVERYBODY BENEFITS
Status:
REGISTERED
Mark Type:
SERVICE MARK
Application Filing Date:
2022-09-14
Mark Drawing Type:
Standard character mark
Mark Literal Elements:
EVERYBODY BENEFITS
USPTO Link:
View Trademark Status and Document Retrieval (TSDR)

Goods And Services

For:
Insurance services, namely, underwriting, issuance and administration of health insurance
First Use:
2022-10-01
International Classes:
036 - Primary Class
Class Status:
Active
Serial Number:
97340100
Mark:
UNIVERA MEDICARE FREEDOM
Status:
REGISTERED
Mark Type:
SERVICE MARK
Application Filing Date:
2022-03-31
Mark Drawing Type:
Standard character mark
Mark Literal Elements:
UNIVERA MEDICARE FREEDOM
USPTO Link:
View Trademark Status and Document Retrieval (TSDR)

Goods And Services

For:
Insurance services, namely, underwriting medicare advantage plan insurance
First Use:
2022-06-01
International Classes:
036 - Primary Class
Class Status:
Active

Motor Carrier Census

Carrier Operation:
Intrastate Non-Hazmat
Phone:
(585) 238-4336
Fax:
(585) 238-4400
Add Date:
2006-06-21
Operation Classification:
Private(Property)
power Units:
1
Drivers:
4
Inspections:
0
FMCSA Link:
View on FMCSA website

Court Cases

Court Case Summary

Filing Date:
2024-04-30
Status:
Pending
Nature Of Judgment:
Missing
Jury Demand:
Plaintiff demands jury
Nature Of Suit:
Other Contract Actions

Parties

Party Name:
EXCELLUS HEALTH PLAN, INC.
Party Role:
Plaintiff
Party Name:
BLACKFLY INVESTMENTS, LLC
Party Role:
Defendant

Court Case Summary

Filing Date:
2022-10-07
Status:
Pending
Nature Of Judgment:
Missing
Jury Demand:
Plaintiff demands jury
Nature Of Suit:
Civil Rights Employment

Parties

Party Name:
RODRIGUEZ
Party Role:
Plaintiff
Party Name:
EXCELLUS HEALTH PLAN, INC.
Party Role:
Defendant
Party Name:
RODRIGUEZ + CO. INC.
Party Role:
Plaintiff

Court Case Summary

Filing Date:
2021-06-30
Status:
Terminated
Nature Of Judgment:
no monetary award
Jury Demand:
Plaintiff demands jury
Nature Of Suit:
Insurance

Parties

Party Name:
HUNTER
Party Role:
Plaintiff
Party Name:
HUNTER, LLC
Party Role:
Plaintiff
Party Name:
EXCELLUS HEALTH PLAN, INC.
Party Role:
Defendant

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Related by address

165 COURT STREET, ROCHESTER, NY, United States, 14647

EXCELLUS HEALTH PLAN COMMUNITY CARE, LLC EXCELLUS VENTURES, INC. LIFETIME BENEFIT SOLUTIONS, INC. LIFETIME WORKFORCE SOLUTIONS, LLC MEDAMERICA, INC. TELAMON LLC NORTH STAR HOME HEALTH MANAGEMENT, INC. EBS-RMSCO INSURANCE AGENCY, INC. 344 SOUTH WARREN STREET CORPORATION

Date of last update: 19 Mar 2025

Sources: New York Secretary of State

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