Form 5500 · Employee benefit plan · NORTHBRIDGE, MA
POLYFOAM LLC
POLYFOAM LLC's employee benefit plan is documented in its annual Form 5500 filing with the Department of Labor. Its broker of record is LOCKTON COMPANIES, LLC. Coverage is written through BLUE CROSS BLUE SHIELD MASSACHUSETTS, INC. and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 84-5102726 · plan 502 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD MASSACHUSETTS, INC. | Health, Dental | 92 | December | $4,421 |
| USABLE LIFE | Life, Disability | 109 | December | $1,875 |
| VISION SERVICE PLAN | Vision | 30 | December | $202 |
Questions
Who is POLYFOAM LLC's benefits broker?
Per its most recent Form 5500 Schedule A, POLYFOAM LLC's broker of record is LOCKTON COMPANIES, LLC.
What insurance carrier does POLYFOAM LLC use?
POLYFOAM LLC's benefit plan is written through BLUE CROSS BLUE SHIELD MASSACHUSETTS, INC., among 3 disclosed carriers.
When does POLYFOAM LLC's group plan renew?
The most recent Schedule A policy period for POLYFOAM LLC ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from POLYFOAM LLC's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.