# PINE STREET INN HEALTH & WELFARE PLAN

Health and welfare plan sponsored by **PINE STREET INN, INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | PINE STREET INN, INC. |
| EIN | 042516093 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | BOSTON, MA |
| Industry | non-profit organization management |
| Funding | fully insured |
| Total premiums | $7.0M |
| Participants | 566 |
| Persons covered | 563 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| HARVARD PILGRIM HEALTH CARE | Health, Rx, HMO, PPO |
| HARTFORD LIFE AND ACCIDENT | Life, STD, LTD, Other |
| BCBS OF MASSACHUSETTS | Dental |
| EYEMED VISION CARE | Vision |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | STD, Other |

## Brokers

| Broker | Placed with |
|---|---|
| BROWN & BROWN INSURANCE SERVICES | HARVARD PILGRIM HEALTH CARE |
| INDIGO INSURANCE SERVICES | HARTFORD LIFE AND ACCIDENT |
| BROWN & BROWN INSURANCE SERVICES | HARTFORD LIFE AND ACCIDENT |
| BROWN & BROWN INSURANCE SERVICES | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. |
| BROWN & BROWN INSURANCE SERVICES | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) |
| FLEURY ENTERPRISES INC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| BROWN & BROWN INSURANCE SERVICES | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ENROLLMENT SOLUTIONS LTD | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| COLGATE BENEFITS INC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| STEPHANIE DECHRISTOFARO | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| SEAN CARNEY | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| MARY-JOYCE LICATA | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| VENESSA N DEAN | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ROSEANN REYNOLDS | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| EILEEN E BERG | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |

## 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/042516093-501
- Cite as: PlanOptica, https://planoptica.com/welfare/042516093-501
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers