Form 5500 · Employee benefit plan · BRATTLEBORO, VT
HOLSTEIN ASSOCIATION USA, INC.
The filing calls this plan HOLSTEIN ASSOCIATION USA, INC. GROUP HEALTH PLAN.
HOLSTEIN ASSOCIATION USA, INC. of BRATTLEBORO, VT files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is RICHARDS, INC.. Coverage is written through BLUE CROSS AND BLUE SHIELD OF VERMONT. The plan's most recent policy period ended in August.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 03-0130760 · plan 506 · plan year 2025, filed Mar 5, 2026
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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 1 insured contract covering health and vision; the largest, with BLUE CROSS AND BLUE SHIELD OF VERMONT, covers 205 people.
Reported premium across the insured contracts is $2,043,626, with $28,240 in disclosed broker commissions — about 1.4% of premium.
The most recent policy period ended in August, and the plan year ends August 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF VERMONT | Health, Vision | 205 | Sep 1, 2025 | $2,043,626 | $28,240 |
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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