Form 5500 · Employee benefit plan · BROOKLINE, MA
BROOKLINE COMMUNITY MENTAL HEALTH
The filing calls this plan BROOKLINE COMMUNITY MENTAL HEALTH HEALTH & WELFARE PLAN.
Public Form 5500 records show how BROOKLINE COMMUNITY MENTAL HEALTH of BROOKLINE, MA, a health care and social assistance employer, structures its employee benefits. Its broker of record is BROWN & BROWN INSURANCE SERVICES, I. Coverage is written through ALTUS DENTAL INSURANCE COMPANY, INC. and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 04-2263744 · plan 501 · plan year 2025, filed Jul 17, 2026
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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
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 3 insured contracts covering dental, vision, life and disability; the largest, with ALTUS DENTAL INSURANCE COMPANY, INC., covers 106 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, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $111,368, with $9,440 in disclosed broker commissions — about 8.5% 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.
BROWN & BROWN INSURANCE SERVICES, I is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 88 | Jan 1, 2026 | $43,201 | $4,765 |
| ALTUS DENTAL INSURANCE COMPANY, INC. | Dental | 106 | Jan 1, 2026 | $60,518 | $3,910 |
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | Vision | 83 | Mar 1, 2025 | $7,649 | $765 |
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
How this plan compares
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