Form 5500 · Employee benefit plan · SPRINGFIELD, MA
SPRINGFIELD INTERNATIONAL CHARTER SCHOOL
The filing calls this plan SPRINGFIELD INTERNATIONAL CHARTER SCHOOL EMPLOYEE BENEFITS PLAN.
SPRINGFIELD INTERNATIONAL CHARTER SCHOOL of SPRINGFIELD, MA is a 229-participant education employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is UNKNOWN. Coverage is written through HEALTH NEW ENGLAND, INC. and 4 other carriers. The plan's most recent policy period ended in June.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 04-3272167 · plan 510 · plan year 2025, filed Sep 10, 2025
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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, 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.
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 HEALTH NEW ENGLAND, INC., covers 169 people.
Reported premium across the insured contracts is $3,170,510, with $76,224 in disclosed broker commissions — about 2.4% of premium.
The most recent policy period ended in June, and the plan year ends June 30. Group contracts typically renew on that annual cycle.
UNKNOWN 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 HEALTH NEW ENGLAND, INC., DELTA DENTAL OF MASSACHUSETTS, UNUM LIFE INSURANCE COMPANY OF AMERICA and EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO.. HEALTH NEW ENGLAND, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HEALTH NEW ENGLAND, INC. | Health | 169 | Jul 1, 2025 | $2,898,496 | $59,653 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 231 | Jul 1, 2025 | $84,677 | $8,640 |
| DELTA DENTAL OF MASSACHUSETTS | Dental | 306 | Jul 1, 2025 | $163,612 | $5,025 |
| UNUM INSURANCE COMPANY | — | 30 | Jul 1, 2025 | $10,795 | $1,619 |
| EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | Vision | 228 | Jul 1, 2025 | $12,930 | $1,287 |
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.
How this plan compares
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