Form 5500 · Employee benefit plan · SHREWSBURY, MA
SUPERCON INCORPORATED
The filing calls this plan SUPERCON, INC. VOLUNTARY EMPLOYEE BENEFIT TRUST.
SUPERCON INCORPORATED of SHREWSBURY, MA is a small manufacturing employer whose insured group plan is on public record in its Form 5500 filing. Its broker of record is HARBOR INSURANCE GROUP LLC. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 04-2484684 · plan 501 · plan year 2025, filed Apr 24, 2026
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How this plan is funded
Both, as reported
The filing reports both insurance premium and benefits paid from the plan's own money, and the two amounts do not line up.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
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.
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 7 insured contracts covering health, dental, vision, life and disability; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 35 people.
Reported premium across the insured contracts is $472,561, with $21,993 in disclosed broker commissions — about 4.7% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
HARBOR INSURANCE GROUP LLC is the broker of record on all 7 contracts.
4 carriers appear on the filing, including UNITEDHEALTHCARE INSURANCE COMPANY, UNITED OF OMAHA LIFE INSURANCE COMPANY, BLUE CROSS BLUE SHIELD OF MASS and VISION SERVICE PLAN. UNITEDHEALTHCARE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY | Health | 35 | Oct 1, 2025 | $371,740 | $13,580 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 44 | Oct 1, 2025 | $32,757 | $3,072 |
| BLUE CROSS BLUE SHIELD OF MASS | Dental | 66 | Oct 1, 2025 | $31,764 | $1,710 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 39 | Oct 1, 2025 | $16,109 | $1,611 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 39 | Oct 1, 2025 | $13,520 | $1,352 |
| VISION SERVICE PLAN | Vision | 25 | Oct 1, 2025 | $3,525 | $353 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 39 | Oct 1, 2025 | $3,146 | $315 |
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: 40 employees, 6 recordable cases, 34 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule I
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
Other plans filed by this employer
How this plan compares
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