Filings through .
History & trajectory Charts need 2 or more years. This plan has 7 years on file; Pro shows them all.
See pricingTotal premium grew more than 20% over the prior year. Good candidate for re-shopping the carriers.
Premium per covered life exceeds 2x the peer median for this NAICS and size cohort. The plan is either richly funded or stuck with a bad rate.
Schedule A insurance contracts: who carries the risk, for which benefits, and how many people they cover.
| Carrier | Coverage | Premium, renewal |
|---|---|---|
Broker: Baystate Benefit Services, Inc LifeSTDLTDHealthDental | LifeSTDLTDHealthDental | Available on Pro |
Broker: Baystate Benefit Services, Inc Vision | Vision | Available on Pro |
See premium, retention and renewal dates for 3 contracts with Pro. Pro shows premium, covered lives, retention, contract numbers and the renewal date for each contract. Free for 7 days, then $49 a month.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 160 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 160 | $968K |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 160 | $968K |
| Vision | EYEMED VISION CARE | 89 | $7K |
| Life insurance | UNITED HEALTHCARE | 160 | $968K |
| Short-term disability | UNITED HEALTHCARE | 160 | $968K |
| Long-term disability | UNITED HEALTHCARE | 160 | $968K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | - |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Brokers paid through Schedule A and service providers paid through Schedule C.
| Broker | Commissions, fees |
|---|---|
Carrier: United Healthcare | Available on Pro |
Carrier: United Healthcare Insurance Company | Available on Pro |
Carrier: Eyemed Vision Care | Available on Pro |
No Schedule C service providers reported on this filing.
How the health and benefits plan is funded and what that means for risk.
3 contacts
7 filings · 2015 to 2025