Form 5500 · Employee benefit plan · BROCKTON, MA
BROCKTON HOSPITAL, INC.
The filing calls this plan SIGNATURE HEALTHCARE EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN.
BROCKTON HOSPITAL, INC. of BROCKTON, MA is a 1,797-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is THE SEGAL CO EASTERN STATES. Coverage is written through DELTA DENTAL OF MASSACHUSETTS and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 22-2472997 · plan 501 · plan year 2025, filed Jul 15, 2026
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1,456 other employer plans in Massachusetts have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
2 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
Also declared: prepaid legal, death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 6 insured contracts covering dental, vision, life and disability; the largest, with DELTA DENTAL OF MASSACHUSETTS, covers 2,355 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on one of the 2 contracts here that do not say what they cover.
Reported premium across the insured contracts is $2,273,219, with $94,286 in disclosed broker commissions — about 4.1% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
THE SEGAL CO EASTERN STATES is the broker of record on 2 of the 6 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 1,799 | Jan 1, 2026 | $554,404 | $56,694 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 1,211 | Jan 1, 2026 | $523,679 | $28,409 |
| METROPOLITAN GENERAL INSURANCE COMPANY | — | 179 | Jan 1, 2026 | $39,789 | $4,264 |
| VISION SERVICE PLAN | Vision | 1,040 | Jan 1, 2026 | $127,256 | $3,122 |
| DELTA DENTAL OF MASSACHUSETTS | Dental | 2,355 | Jan 1, 2026 | $962,750 | $1,797 |
| KGA | — | 2,669 | Jan 1, 2026 | $65,341 | $0 |
Premium and claims on these contracts
VISION SERVICE PLAN, contract 30017667. For the contract year on this filing, the carrier reported $127,256 in premium earned and $75,035 in claims incurred. Dividing one by the other gives 59%.
DELTA DENTAL OF MASSACHUSETTS, contract 0011880000. For the contract year on this filing, the carrier reported $962,750 in premium earned and $879,283 in claims incurred. Dividing one by the other gives 91%.
- VISION SERVICE PLAN, contract 30017667 reported $24,815 in retention.
- DELTA DENTAL OF MASSACHUSETTS, contract 0011880000 reported $83,467 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
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