Form 5500 · Employee benefit plan · PORTLAND, ME
PREBLE STREET
The filing calls this plan PREBLE STREET HEALTH & WELFARE BENEFIT PLAN.
PREBLE STREET of PORTLAND, ME insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is CROSS BENEFIT SOLUTIONS. Coverage is written through HARVARD PILGRIM HEALTH CARE and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 01-0418917 · plan 501 · plan year 2025, filed Sep 1, 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
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.
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 4 insured contracts covering health, dental, vision, life and disability; the largest, with HARVARD PILGRIM HEALTH CARE, covers 389 people.
Reported premium across the insured contracts is $2,991,716, with $78,109 in disclosed broker commissions — about 2.6% 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.
CROSS BENEFIT SOLUTIONS is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including HARVARD PILGRIM HEALTH CARE, DELTA DENTAL PLAN OF MAINE, UNUM LIFE INSURANCE COMPANY OF AMERICA and ANTHEM HEALTH PLANS OF MAINE, INC.. HARVARD PILGRIM HEALTH CARE writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HARVARD PILGRIM HEALTH CARE | Health | 389 | Jan 1, 2026 | $2,681,762 | $59,620 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 250 | Jan 1, 2026 | $129,526 | $11,339 |
| DELTA DENTAL PLAN OF MAINE | Dental | 408 | Jan 1, 2026 | $166,550 | $5,763 |
| ANTHEM HEALTH PLANS OF MAINE, INC. | Vision | 443 | Jan 1, 2026 | $13,878 | $1,387 |
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.
Reported to OSHA
Reported to OSHA for 2025: 328 employees, 12 recordable cases, 181 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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