Form 5500 · Employee benefit plan · WILLISTON, VT
PCHP-MEDICAL SERVICES ORGANAZATION LLP
The filing calls this plan PRIMARY CARE HEALTH PARTNERS HEALTH AND WELFARE PLAN.
PCHP-MEDICAL SERVICES ORGANAZATION LLP of WILLISTON, VT insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is PAYCHEX INSURANCE AGENCY INC. Coverage is written through BLUE CROSS AND BLUE SHIELD OF VERMONT and 7 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 03-0362571 · plan 506 · plan year 2024, filed Jul 30, 2025
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
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: 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.
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 13 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CROSS AND BLUE SHIELD OF VERMONT, covers 56 people.
Reported premium across the insured contracts is $1,146,244, with $50,296 in disclosed broker commissions — about 4.4% 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.
PAYCHEX INSURANCE AGENCY INC is the broker of record on 4 of the 13 contracts; the rest name a different broker or none.
8 carriers appear on the filing, including BLUE CROSS AND BLUE SHIELD OF VERMONT, UNUM LIFE INSURANCE COMPANY OF AMERICA, DELTA DENTAL PLAN OF VERMONT, INC. and COLONIAL LIFE & ACCIDENT INSURANCE COMPANY. BLUE CROSS AND BLUE SHIELD OF VERMONT writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | 36 | Jan 1, 2025 | $45,404 | $27,888 |
| DELTA DENTAL PLAN OF VERMONT, INC. | Dental | 212 | Jan 1, 2025 | $82,485 | $4,876 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 159 | Jan 1, 2025 | $84,125 | $4,398 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Disability | 151 | Jan 1, 2025 | $37,731 | $3,887 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | — | 52 | Jan 1, 2025 | $22,277 | $3,342 |
| VISION SERVICE PLAN | Vision | 87 | Jan 1, 2025 | $15,206 | $2,277 |
| THE PAUL REVERE LIFE INSURANCE COMPANY | — | 6 | Jan 1, 2025 | $3,959 | $2,182 |
| MVP HEALTHCARE | Health | 2 | Jan 1, 2025 | $23,024 | $844 |
| HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC. | Health | 1 | Jan 1, 2025 | $11,420 | $602 |
| BLUE CROSS AND BLUE SHIELD OF VERMONT | Health | 56 | Jan 1, 2025 | $414,652 | $0 |
| BLUE CROSS AND BLUE SHIELD OF VERMONT | Health | 37 | Jan 1, 2025 | $303,508 | $0 |
| BLUE CROSS AND BLUE SHIELD OF VERMONT | Health | 10 | Jan 1, 2025 | $86,610 | $0 |
| BLUE CROSS AND BLUE SHIELD OF VERMONT | Health | 2 | Jan 1, 2025 | $15,843 | $0 |
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
Subscribers see how this compares with similar plans in Vermont. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
More employer plans in Vermont — largest plans, brokers, carriers and renewal months.