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| Plan Name | BLACK DIAMOND NETWORKS, INC. LIFE AND DISABILITY PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BLACK DIAMOND NETWORKS, INC. |
| Employer identification number (EIN): | 043451651 |
| NAIC Classification: | 561300 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-07-01 | TIM SHOULDERS | 2024-04-15 | ||
| 501 | 2021-07-01 | CHRISTOPHER HEALEY | 2023-02-16 | ||
| 501 | 2020-07-01 | CHRISTOPHER HEALEY | 2022-03-10 | ||
| 501 | 2019-07-01 | ALEXANDER M. ASHCRAFT | 2021-02-17 | ||
| 501 | 2018-07-01 | ||||
| 501 | 2018-07-01 | ALEXANDER M. ASHCRAFT | 2021-02-17 | ||
| 501 | 2017-07-01 | ||||
| 501 | 2017-01-01 | CHRISTOPHER HEALEY | |||
| 501 | 2016-01-01 | CHRISTOPHER HEALEY | CHRISTOPHER HEALEY | 2017-07-24 | |
| 501 | 2015-01-01 | CHRISTOPHER HEALEY |
| 2022: BLACK DIAMOND NETWORKS, INC. LIFE AND DISABILITY PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Submission has been amended | No |
| 2022-07-01 | This submission is the final filing | No |
| 2022-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-07-01 | Plan is a collectively bargained plan | No |
| 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: BLACK DIAMOND NETWORKS, INC. LIFE AND DISABILITY PLAN 2021 form 5500 responses | ||
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Submission has been amended | No |
| 2021-07-01 | This submission is the final filing | No |
| 2021-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-07-01 | Plan is a collectively bargained plan | No |
| 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: BLACK DIAMOND NETWORKS, INC. LIFE AND DISABILITY PLAN 2020 form 5500 responses | ||
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Submission has been amended | No |
| 2020-07-01 | This submission is the final filing | No |
| 2020-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-07-01 | Plan is a collectively bargained plan | No |
| 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 |
| 2019: BLACK DIAMOND NETWORKS, INC. LIFE AND DISABILITY PLAN 2019 form 5500 responses | ||
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: BLACK DIAMOND NETWORKS, INC. LIFE AND DISABILITY PLAN 2018 form 5500 responses | ||
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Submission has been amended | Yes |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: BLACK DIAMOND NETWORKS, INC. LIFE AND DISABILITY PLAN 2017 form 5500 responses | ||
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 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) | Yes |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: BLACK DIAMOND NETWORKS, INC. LIFE AND DISABILITY PLAN 2016 form 5500 responses | ||
| 2016-01-01 | Type of plan entity | Single employer plan |
| 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 benefit arrangement – Insurance | Yes |
| 2015: BLACK DIAMOND NETWORKS, INC. LIFE AND DISABILITY PLAN 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 0176310 |
| Policy instance | 5 |
| HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) | |
| Policy contract number | 107596 |
| Policy instance | 4 |
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) | |
| Policy contract number | 107595 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00575767 |
| Policy instance | 2 |
| LONDON HEALTH ADMINISTRATORS (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | LHABDIAMOND |
| Policy instance | 1 |
| LONDON HEALTH ADMINISTRATORS (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | LHABDIAMOND |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00575767 |
| Policy instance | 2 |
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) | |
| Policy contract number | 107595 |
| Policy instance | 3 |
| HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) | |
| Policy contract number | 107596 |
| Policy instance | 4 |
| HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) | |
| Policy contract number | 107596 |
| Policy instance | 4 |
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) | |
| Policy contract number | 107595 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00575767 |
| Policy instance | 2 |
| LONDON HEALTH ADMINISTRATORS (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | LHABDIAMOND |
| Policy instance | 1 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |
| Policy contract number | 50035781 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) | |
| Policy contract number | 8025357 |
| Policy instance | 1 |
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) | |
| Policy contract number | 013763 |
| Policy instance | 6 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD604944 |
| Policy instance | 5 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD604945 |
| Policy instance | 4 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM604870 |
| Policy instance | 3 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK603306 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) | |
| Policy contract number | 8025357 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) | |
| Policy contract number | 8025357 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK603306 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD604945 |
| Policy instance | 4 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGN604870 |
| Policy instance | 3 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD604944 |
| Policy instance | 5 |
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) | |
| Policy contract number | 013763 |
| Policy instance | 6 |
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) | |
| Policy contract number | 0137639901 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) | |
| Policy contract number | 8025357 |
| Policy instance | 1 |
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