Form 5500 · Employee benefit plan · SPRINGFIELD, MA
COMMUNITY SERVICES INSTITUTE, INC.
The filing calls this plan COMMUNITY SERVICES INSTITUTE, INC. DISABILITY PLAN.
COMMUNITY SERVICES INSTITUTE, INC. of SPRINGFIELD, MA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is UNKNOWN. Coverage is written through HEALTH NEW ENGLAND, INC. and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 04-2927887 · plan 501 · plan year 2023, filed Jul 27, 2024
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How this plan is funded
Both, as reported
The medical insurance contracts on the filing cover fewer than half the people in the plan, so the rest is paid another way.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Also declared: 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 4 insured contracts covering health, dental, vision, life and disability; the largest, with HEALTH NEW ENGLAND, INC., covers 42 people.
Reported premium across the insured contracts is $560,670, with $25,700 in disclosed broker commissions — about 4.6% 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.
UNKNOWN is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including HEALTH NEW ENGLAND, INC., UNITED OF OMAHA LIFE INSURANCE COMPANY, BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. and SUN LIFE ASSURANCE COMPANY OF CANADA. HEALTH NEW ENGLAND, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HEALTH NEW ENGLAND, INC. | Health | 42 | Jan 1, 2024 | $464,925 | $17,267 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life, Disability | 119 | Jan 1, 2024 | $55,300 | $5,524 |
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | Dental | 59 | Jan 1, 2024 | $35,921 | $2,457 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Vision | 28 | Jan 1, 2024 | $4,524 | $452 |
Premium and claims on this contract
HEALTH NEW ENGLAND, INC., contract 117935. For the contract year on this filing, the carrier reported $464,925 in premium earned and $464,926 in claims incurred. Dividing one by the other gives 100%.
- HEALTH NEW ENGLAND, INC., contract 117935 reported $17,267 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
How this plan compares
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