Form 5500 · Employee benefit plan · NORTH BILLERICA, MA
POTPOURRI GROUP, INC.
The filing calls this plan POTPOURRI GROUP, INC. EMPLOYEE BENEFIT PLAN.
POTPOURRI GROUP, INC. of NORTH BILLERICA, MA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is APEX BENEFITS PARTNERS, INC.. Coverage is written through BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. and 4 other carriers. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 52-2078918 · plan 501 · plan year 2025, filed Nov 11, 2025
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127 other employer plans in Massachusetts have policy years ending in May. 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: 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 5 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., covers 367 people.
Reported premium across the insured contracts is $2,328,782, with $152,751 in disclosed broker commissions — about 6.6% of premium.
The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.
APEX BENEFITS PARTNERS, INC. is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., USABLE LIFE, COLONIAL LIFE & ACCIDENT INSURANCE COMPANY and DELTA DENTAL PLAN OF MAINE. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | Health | 367 | Jun 1, 2025 | $2,044,870 | $85,309 |
| USABLE LIFE | Life, Disability | 334 | Jun 1, 2025 | $195,719 | $44,033 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | Life | 37 | Jun 1, 2025 | $34,930 | $19,082 |
| METROPOLITAN LIFE INSURANCE COMPANY | Vision | 284 | Jun 1, 2025 | $19,987 | $2,633 |
| DELTA DENTAL PLAN OF MAINE | Dental | 57 | Jun 1, 2025 | $33,276 | $1,694 |
Premium and claims on this contract
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 4957179. For the contract year on this filing, the carrier reported $2,044,870 in premium earned and $2,504,121 in claims incurred. Dividing one by the other gives 122%.
- BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 4957179 reported $-459,252 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.
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: 302 employees, 9 recordable cases, 152 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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