401k Plan data: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN plan

THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 401k Plan overview

Plan Name	THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN
Plan identification number	510

THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

CHARLES STARK DRAPER LABORATORY has sponsored the creation of one or more 401k plans.

Company Name: CHARLES STARK DRAPER LABORATORY

Employer identification number (EIN): 042505372

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2022-01-01
510 2021-01-01
510 2021-01-01
510 2020-01-01
510 2019-01-01
510 2018-01-01
510 2017-01-01 ELIZABETH MORA
510 2017-01-01
510 2016-01-01 DEBRA EDWARDS 2018-05-22

Plan Statistics for THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN

401k plan membership statisitcs for THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN

Measure Date Value
2022: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 680
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 648
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 648
2021: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 705
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
Number of retired or separated participants receiving benefits 2021-01-01 680
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 680
2020: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 680
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 705
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 705
2019: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 678
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 680
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 680
2018: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 612
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Number of retired or separated participants receiving benefits 2018-01-01 678
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 678
2017: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 937
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 606
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 606
2016: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2,382
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,636
Number of retired or separated participants receiving benefits 2016-01-01 937
Total of all active and inactive participants 2016-01-01 2,573
Total participants 2016-01-01 2,573

Measure	Date	Value
2022: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	680
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	648
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	648
2021: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	705
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	680
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	680
2020: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	680
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	705
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	705
2019: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	678
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	680
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	680
2018: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	612
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Number of retired or separated participants receiving benefits	2018-01-01	678
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	678
2017: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	937
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	606
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	606
2016: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2,382
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,636
Number of retired or separated participants receiving benefits	2016-01-01	937
Total of all active and inactive participants	2016-01-01	2,573
Total participants	2016-01-01	2,573

Financial Data on THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN

Measure	Date	Value
2022 : THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$-4,478,680
Total unrealized appreciation/depreciation of assets	2022-12-31	$-4,478,680
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-3,256,272
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,153,860
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,007,569
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$683,604
Value of total assets at end of year	2022-12-31	$22,812,975
Value of total assets at beginning of year	2022-12-31	$27,223,107
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$146,291
Total interest from all sources	2022-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$538,804
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$538,804
Administrative expenses professional fees incurred	2022-12-31	$146,291
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$210,779
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$73
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$144,233
Total non interest bearing cash at beginning of year	2022-12-31	$152,278
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-4,410,132
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$22,812,975
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$27,223,107
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$12,108,699
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$14,648,398
Value of interest in common/collective trusts at end of year	2022-12-31	$10,559,970
Value of interest in common/collective trusts at beginning of year	2022-12-31	$12,422,431
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$14,400
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$472,825
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$993,169
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	CARON & BLETZER
Accountancy firm EIN	2022-12-31	043499945
2021 : THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2021-12-31	$1,976,704
Total unrealized appreciation/depreciation of assets	2021-12-31	$1,976,704
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$4,120,732
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,335,730
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,150,910
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$824,931
Value of total assets at end of year	2021-12-31	$27,198,332
Value of total assets at beginning of year	2021-12-31	$24,413,330
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$184,820
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$1,319,097
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$1,319,097
Administrative expenses professional fees incurred	2021-12-31	$184,820
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$162,467
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$127,503
Total non interest bearing cash at beginning of year	2021-12-31	$103,637
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$2,785,002
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$27,198,332
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$24,413,330
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$14,648,398
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$14,270,863
Value of interest in common/collective trusts at end of year	2021-12-31	$12,422,431
Value of interest in common/collective trusts at beginning of year	2021-12-31	$10,038,830
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$336,818
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$824,931
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$814,092
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	CARON & BLETZER
Accountancy firm EIN	2021-12-31	043499945
2020 : THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$2,502,346
Total unrealized appreciation/depreciation of assets	2020-12-31	$2,502,346
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$3,448,547
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,190,458
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,090,075
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$720,815
Value of total assets at end of year	2020-12-31	$24,413,330
Value of total assets at beginning of year	2020-12-31	$22,155,241
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$100,383
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$225,386
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$225,386
Administrative expenses professional fees incurred	2020-12-31	$100,383
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$192,045
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$31
Total non interest bearing cash at end of year	2020-12-31	$103,637
Total non interest bearing cash at beginning of year	2020-12-31	$128,384
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$2,258,089
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$24,413,330
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$22,155,241
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$14,270,863
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$23,671
Value of interest in common/collective trusts at end of year	2020-12-31	$10,038,830
Value of interest in common/collective trusts at beginning of year	2020-12-31	$22,003,155
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$232,970
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$528,770
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$857,105
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	CARON & BLETZER
Accountancy firm EIN	2020-12-31	043499945
2019 : THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$4,830,346
Total income from all sources (including contributions)	2019-12-31	$4,830,346
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,205,573
Total of all expenses incurred	2019-12-31	$1,205,573
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,117,623
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,117,623
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$754,069
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$754,069
Value of total assets at end of year	2019-12-31	$22,155,241
Value of total assets at beginning of year	2019-12-31	$18,530,468
Value of total assets at beginning of year	2019-12-31	$18,530,468
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$87,950
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$87,950
Total interest from all sources	2019-12-31	$0
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$440,884
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$440,884
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$440,884
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$440,884
Administrative expenses professional fees incurred	2019-12-31	$87,950
Administrative expenses professional fees incurred	2019-12-31	$87,950
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$191,312
Contributions received from participants	2019-12-31	$191,312
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$31
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$13,341
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$13,341
Total non interest bearing cash at end of year	2019-12-31	$128,384
Total non interest bearing cash at end of year	2019-12-31	$128,384
Total non interest bearing cash at beginning of year	2019-12-31	$121,078
Total non interest bearing cash at beginning of year	2019-12-31	$121,078
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$3,624,773
Value of net income/loss	2019-12-31	$3,624,773
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$22,155,241
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$18,530,468
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$18,530,468
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$23,671
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$18,396,049
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$18,396,049
Value of interest in common/collective trusts at end of year	2019-12-31	$22,003,155
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$272,071
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$272,071
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$3,635,393
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$3,635,393
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$562,757
Contributions received in cash from employer	2019-12-31	$562,757
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$845,552
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$845,552
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CARON & BLETZER
Accountancy firm name	2019-12-31	CARON & BLETZER
Accountancy firm EIN	2019-12-31	043499945
Accountancy firm EIN	2019-12-31	043499945
2018 : THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$-833,650
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,224,150
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,105,843
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$328,006
Value of total assets at end of year	2018-12-31	$18,530,468
Value of total assets at beginning of year	2018-12-31	$20,588,268
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$118,307
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$917,873
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$917,873
Administrative expenses professional fees incurred	2018-12-31	$118,307
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$191,662
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$13,341
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$11,143
Total non interest bearing cash at end of year	2018-12-31	$121,078
Total non interest bearing cash at beginning of year	2018-12-31	$100,787
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-2,057,800
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$18,530,468
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$20,588,268
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$18,396,049
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$20,450,061
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$238,618
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-2,079,529
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$136,344
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$26,277
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$867,225
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	CARON & BLETZER
Accountancy firm EIN	2018-12-31	043499945
2017 : THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$0
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$0
Value of total assets at end of year	2017-12-31	$69,498
Value of total assets at beginning of year	2017-12-31	$69,498
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$0
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$853,924
Administrative expenses professional fees incurred	2017-12-31	$73,611
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$232,877
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$11,143
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$10,005
Total non interest bearing cash at end of year	2017-12-31	$69,498
Total non interest bearing cash at beginning of year	2017-12-31	$69,498
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$0
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$69,498
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$69,498
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$20,450,061
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$17,788,946
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$343,314
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$1,881,941
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$1,035,662
Employer contributions (assets) at end of year	2017-12-31	$26,277
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$867,660
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	CARON & BLETZER
Accountancy firm EIN	2017-12-31	043499945
2016 : THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$3,178,371
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,366,329
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,300,459
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,369,957
Value of total assets at end of year	2016-12-31	$17,868,449
Value of total assets at beginning of year	2016-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$65,870
Total interest from all sources	2016-12-31	$556,228
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Administrative expenses professional fees incurred	2016-12-31	$65,870
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$319,681
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$10,005
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Total non interest bearing cash at end of year	2016-12-31	$69,498
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$1,812,042
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$17,868,449
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$17,788,946
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$0
Interest earned on other investments	2016-12-31	$556,228
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$465,786
Net gain/loss from 103.12 investment entities	2016-12-31	$1,252,186
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$1,050,276
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$834,673
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	CARON & BLETZER
Accountancy firm EIN	2016-12-31	043499945

Form 5500 Responses for THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN

2022: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: THE CHARLES STARK DRAPER LABORATORY, INC. RETIRED EMPLOYEES MEDICAL BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

4958955

Policy instance

Insurance contract or identification number	4958955
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $14,400
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

4958955

Policy instance

Insurance contract or identification number	4958955
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
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

4958955

Policy instance

Insurance contract or identification number	4958955
Number of Individuals Covered	32
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $235,785
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

4958955

Policy instance

Insurance contract or identification number	4958955
Number of Individuals Covered	5095
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $28,026,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )

Policy contract number

011646

Policy instance

Insurance contract or identification number	011646
Number of Individuals Covered	21
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $241,701
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )

Policy contract number

016420

Policy instance

Insurance contract or identification number	016420
Number of Individuals Covered	185
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,349,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )

Policy contract number

011646

Policy instance

Insurance contract or identification number	011646
Number of Individuals Covered	32
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $311,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )

Policy contract number

011647

Policy instance

Insurance contract or identification number	011647
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $16,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	CHARLES STARK DRAPER LABORATORY
Employer identification number (EIN):	042505372
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations