Form 5500 · Employee benefit plan · BOSTON, MA
UNISPACE OF BOSTON, LLC
The filing calls this plan UNISPACE OF BOSTON, LLC EMPLOYEE BENEFITS PLAN.
Public Form 5500 records show how UNISPACE OF BOSTON, LLC of BOSTON, MA, a construction employer, structures its employee benefits. Its broker of record is BROWN & BROWN MA. Coverage is written through BLUE CROSS BLUE SHIELD OF 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 90-0793408 · plan 501 · plan year 2023, filed May 29, 2024
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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: 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 4 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., covers 212 people.
Reported premium across the insured contracts is $2,003,094, with $68,142 in disclosed broker commissions — about 3.4% 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.
BROWN & BROWN MA is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA and METROPOLITAN LIFE INSURANCE COMPANY. 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 | 212 | Jan 1, 2024 | $1,776,914 | $53,071 |
| EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 117 | Jan 1, 2024 | $108,410 | $8,529 |
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | Dental | 210 | Jan 1, 2024 | $106,590 | $5,295 |
| METROPOLITAN LIFE INSURANCE COMPANY | Vision | 230 | Jan 1, 2024 | $11,180 | $1,247 |
Premium and claims on these contracts
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 8056075. For the contract year on this filing, the carrier reported $1,776,914 in premium earned and $1,411,578 in claims incurred. Dividing one by the other gives 79%.
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 8056075. For the contract year on this filing, the carrier reported $106,590 in premium earned and $92,381 in claims incurred. Dividing one by the other gives 87%.
- BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 8056075 reported $365,336 in retention.
- BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 8056075 reported $14,209 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.
Other plans filed by this employer
How this plan compares
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