Form 5500 · Employee benefit plan · RANDOLPH, MA
EMERSON SWAN
The filing calls this plan EMERSON SWAN HEALTH AND WELFARE PLAN.
EMERSON SWAN of RANDOLPH, MA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is BROWN & BROWN OF MA, LLC. Coverage is written through BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. and 1 other carrier. The plan's most recent policy period ended in April.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-0688536 · plan 501 · plan year 2025, filed Dec 23, 2025
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89 other employer plans in Massachusetts have policy years ending in April. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
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 2 insured contracts covering health and life; the largest, with BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., covers 575 people.
The filing declares health, life and dental. Dental 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 $5,302,755, with $134,311 in disclosed broker commissions — about 2.5% of premium.
The most recent policy period ended in April, and the plan year ends April 30. Group contracts typically renew on that annual cycle.
BROWN & BROWN OF MA, LLC is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | Health | 575 | May 1, 2025 | $5,242,039 | $131,275 |
| EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | Life | 195 | May 1, 2025 | $60,716 | $3,036 |
Premium and claims on this contract
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 4947828. For the contract year on this filing, the carrier reported $5,242,039 in premium earned and $5,001,067 in claims incurred. Dividing one by the other gives 95%.
- BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 4947828 reported $240,972 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.
How this plan compares
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Renewal calendar
89 other employer plans in Massachusetts are May 1 renewals (policy year ends April).
Their policy years end in April, like this plan’s, so most renew May 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
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