401k Plan data: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN plan

THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN
Plan identification number	506

THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BERKSHIRE SCHOOL, INC. has sponsored the creation of one or more 401k plans.

Company Name: BERKSHIRE SCHOOL, INC.

Employer identification number (EIN): 042121313

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2023-07-01 ROBERT BOYD 2024-12-02
506 2022-07-01 ROBERT BOYD 2023-10-23
506 2021-07-01 ROBERT BOYD 2022-11-17
506 2020-07-01 ROBERT BOYD 2021-12-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
506	2023-07-01	ROBERT BOYD	2024-12-02
506	2022-07-01	ROBERT BOYD	2023-10-23
506	2021-07-01	ROBERT BOYD	2022-11-17
506	2020-07-01	ROBERT BOYD	2021-12-15

Plan Statistics for THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2023: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-07-01 184
Total number of active participants reported on line 7a of the Form 5500 2023-07-01 178
Number of retired or separated participants receiving benefits 2023-07-01 2
Number of other retired or separated participants entitled to future benefits 2023-07-01 0
Total of all active and inactive participants 2023-07-01 180
Number of employers contributing to the scheme 2023-07-01 0
2022: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-07-01 204
Total number of active participants reported on line 7a of the Form 5500 2022-07-01 180
Number of retired or separated participants receiving benefits 2022-07-01 25
Number of other retired or separated participants entitled to future benefits 2022-07-01 0
Total of all active and inactive participants 2022-07-01 205
Number of employers contributing to the scheme 2022-07-01 0
2021: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 200
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 177
Number of retired or separated participants receiving benefits 2021-07-01 27
Number of other retired or separated participants entitled to future benefits 2021-07-01 0
Total of all active and inactive participants 2021-07-01 204
Number of employers contributing to the scheme 2021-07-01 0
2020: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 179
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 175
Number of retired or separated participants receiving benefits 2020-07-01 12
Number of other retired or separated participants entitled to future benefits 2020-07-01 0
Total of all active and inactive participants 2020-07-01 187
Number of employers contributing to the scheme 2020-07-01 0

Measure	Date	Value
2023: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-07-01	184
Total number of active participants reported on line 7a of the Form 5500	2023-07-01	178
Number of retired or separated participants receiving benefits	2023-07-01	2
Number of other retired or separated participants entitled to future benefits	2023-07-01	0
Total of all active and inactive participants	2023-07-01	180
Number of employers contributing to the scheme	2023-07-01	0
2022: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-07-01	204
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	180
Number of retired or separated participants receiving benefits	2022-07-01	25
Number of other retired or separated participants entitled to future benefits	2022-07-01	0
Total of all active and inactive participants	2022-07-01	205
Number of employers contributing to the scheme	2022-07-01	0
2021: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	200
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	177
Number of retired or separated participants receiving benefits	2021-07-01	27
Number of other retired or separated participants entitled to future benefits	2021-07-01	0
Total of all active and inactive participants	2021-07-01	204
Number of employers contributing to the scheme	2021-07-01	0
2020: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	179
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	175
Number of retired or separated participants receiving benefits	2020-07-01	12
Number of other retired or separated participants entitled to future benefits	2020-07-01	0
Total of all active and inactive participants	2020-07-01	187
Number of employers contributing to the scheme	2020-07-01	0

Form 5500 Responses for THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN

2023: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-07-01	Type of plan entity	Single employer plan
2023-07-01	Plan funding arrangement – Insurance	Yes
2023-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-07-01	Plan benefit arrangement – Insurance	Yes
2023-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-07-01	Type of plan entity	Single employer plan
2022-07-01	Plan funding arrangement – Insurance	Yes
2022-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-07-01	Plan benefit arrangement – Insurance	Yes
2022-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: THE BERKSHIRE SCHOOL, INC. HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	First time form 5500 has been submitted	Yes
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0ASYR

Policy instance

Insurance contract or identification number	GLUG0ASYR
Number of Individuals Covered	178
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $9,089
Total amount of fees paid to insurance company	USD $5,642
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $93,539
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

376863

Policy instance

Insurance contract or identification number	376863
Number of Individuals Covered	130
Insurance policy start date	2023-06-01
Insurance policy end date	2024-05-31
Total amount of commissions paid to insurance broker	USD $174
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )

Policy contract number

19640052

Policy instance

Insurance contract or identification number	19640052
Number of Individuals Covered	181
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $1,146
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $101,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0ASYR

Policy instance

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

376863

Policy instance

DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )

Policy contract number

19640052

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0ASYR

Policy instance

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

376863

Policy instance

DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )

Policy contract number

19640052

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0ASYR

Policy instance

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

6395660

Policy instance

DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )

Policy contract number

19640052

Policy instance

Potentially related plans

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Company Name:	BERKSHIRE SCHOOL, INC.
Employer identification number (EIN):	042121313
NAIC Classification:	611000