Form 5500 · Employee benefit plan · WHITEFIELD, NH
NORTH COUNTRY HEALTHCARE
The filing calls this plan NORTH COUNTRY HEALTHCARE WELFARE BENEFIT PLAN.
NORTH COUNTRY HEALTHCARE of WHITEFIELD, NH files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is CGI BUSINESS SOLUTIONS. Coverage is written through HARVARD PILGRIM HEALTH CARE OF NE INC - MA and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 81-2225283 · plan 501 · plan year 2025, filed May 21, 2026
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287 other employer plans in New Hampshire 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
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
Also declared: prepaid legal, death benefits.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 health, dental, vision, life and disability; the largest, with HARVARD PILGRIM HEALTH CARE OF NE INC - MA, covers 699 people.
Reported premium across the insured contracts is $17,808,265, with $579,706 in disclosed broker commissions — about 3.3% 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.
CGI BUSINESS SOLUTIONS is the broker of record on 1 of the 6 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including HARVARD PILGRIM HEALTH CARE OF NE INC - MA, UNUM LIFE INSURANCE COMPANY OF AMERICA, DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. and CONTINENTAL AMERICAN INSURANCE COMPANY. HARVARD PILGRIM HEALTH CARE OF NE INC - MA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HARVARD PILGRIM HEALTH CARE OF NE INC - MA | Health | 699 | Jan 1, 2026 | $15,365,917 | $362,120 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 984 | Jan 1, 2026 | $1,449,715 | $142,119 |
| CONTINENTAL AMERICAN INSURANCE COMPANY | Health | 294 | Jan 1, 2026 | $160,399 | $40,152 |
| DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | Dental | 431 | Jan 1, 2026 | $725,393 | $24,229 |
| VISION SERVICE PLAN | Vision | 525 | Jan 1, 2026 | $86,313 | $9,375 |
| METLIFE LEGAL PLANS | — | 71 | Jan 1, 2026 | $20,528 | $1,711 |
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.
Reported to OSHA
Reported to OSHA for 2025: 235 employees, 1 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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Renewal calendar
287 other employer plans in New Hampshire are January 1 renewals (policy year ends December).
Their policy years end in December, like this plan’s, so most renew January 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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