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COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 401k Plan overview

Plan NameCOMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC.
Plan identification number 501

COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

COMMUNITY SERVICES FOR EVERY1 INC has sponsored the creation of one or more 401k plans.

Company Name:COMMUNITY SERVICES FOR EVERY1 INC
Employer identification number (EIN):161317369
NAIC Classification:624100
NAIC Description: Individual and Family Services

Additional information about COMMUNITY SERVICES FOR EVERY1 INC

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1987-02-10
Company Identification Number: 1143562
Legal Registered Office Address: ATTN: MINDY CERVONI
180 OAK STREET
BUFFALO
United States of America (USA)
14203

More information about COMMUNITY SERVICES FOR EVERY1 INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-03-01
5012021-03-01
5012020-03-01
5012019-03-01
5012018-03-01MINDY CERVONI
5012017-03-01MINDY CERVONI
5012016-03-01MINDY CERVONI
5012015-03-01MINDY CERVONI
5012014-03-01MINDY CERVONI
5012013-03-01MARK R. FOLEY
5012012-03-01MARK R. FOLEY
5012011-03-01MARK R. FOLEY
5012009-03-01MARK R FOLEY

Plan Statistics for COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC.

401k plan membership statisitcs for COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC.

Measure Date Value
2022: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2022 401k membership
Total participants, beginning-of-year2022-03-01458
Total number of active participants reported on line 7a of the Form 55002022-03-01443
Total of all active and inactive participants2022-03-01443
2021: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2021 401k membership
Total participants, beginning-of-year2021-03-01501
Total number of active participants reported on line 7a of the Form 55002021-03-01458
Total of all active and inactive participants2021-03-01458
2020: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2020 401k membership
Total participants, beginning-of-year2020-03-01527
Total number of active participants reported on line 7a of the Form 55002020-03-01501
Total of all active and inactive participants2020-03-01501
2019: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2019 401k membership
Total participants, beginning-of-year2019-03-01215
Total number of active participants reported on line 7a of the Form 55002019-03-01527
Total of all active and inactive participants2019-03-01527
2018: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2018 401k membership
Total participants, beginning-of-year2018-03-01254
Total number of active participants reported on line 7a of the Form 55002018-03-01214
Number of retired or separated participants receiving benefits2018-03-011
Total of all active and inactive participants2018-03-01215
2017: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2017 401k membership
Total participants, beginning-of-year2017-03-01382
Total number of active participants reported on line 7a of the Form 55002017-03-01376
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-01376
2016: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2016 401k membership
Total participants, beginning-of-year2016-03-01412
Total number of active participants reported on line 7a of the Form 55002016-03-01382
Number of retired or separated participants receiving benefits2016-03-010
Number of other retired or separated participants entitled to future benefits2016-03-010
Total of all active and inactive participants2016-03-01382
2015: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2015 401k membership
Total participants, beginning-of-year2015-03-01412
Total number of active participants reported on line 7a of the Form 55002015-03-01355
Number of retired or separated participants receiving benefits2015-03-010
Number of other retired or separated participants entitled to future benefits2015-03-010
Total of all active and inactive participants2015-03-01355
2014: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2014 401k membership
Total participants, beginning-of-year2014-03-01397
Total number of active participants reported on line 7a of the Form 55002014-03-01436
Total of all active and inactive participants2014-03-01436
2013: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2013 401k membership
Total participants, beginning-of-year2013-03-01336
Total number of active participants reported on line 7a of the Form 55002013-03-01397
Total of all active and inactive participants2013-03-01397
2012: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2012 401k membership
Total participants, beginning-of-year2012-03-01346
Total number of active participants reported on line 7a of the Form 55002012-03-01336
Total of all active and inactive participants2012-03-01336
2011: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2011 401k membership
Total participants, beginning-of-year2011-03-01389
Total number of active participants reported on line 7a of the Form 55002011-03-01345
Total of all active and inactive participants2011-03-01345
2009: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2009 401k membership
Total participants, beginning-of-year2009-03-01359
Total number of active participants reported on line 7a of the Form 55002009-03-01380
Total of all active and inactive participants2009-03-01380
Total participants2009-03-01380

Form 5500 Responses for COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC.

2022: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes
2016: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan benefit arrangement – InsuranceYes
2015: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2015 form 5500 responses
2015-03-01Type of plan entitySingle employer plan
2015-03-01Plan funding arrangement – InsuranceYes
2015-03-01Plan benefit arrangement – InsuranceYes
2014: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2014 form 5500 responses
2014-03-01Type of plan entitySingle employer plan
2014-03-01Plan funding arrangement – InsuranceYes
2014-03-01Plan benefit arrangement – InsuranceYes
2013: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2013 form 5500 responses
2013-03-01Type of plan entitySingle employer plan
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2009: COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC. 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number21588
Policy instance 3
Insurance contract or identification number21588
Number of Individuals Covered49
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $662,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number21588
Policy instance 2
Insurance contract or identification number21588
Number of Individuals Covered108
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $32,704
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $988,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,704
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered335
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $18,384
Total amount of fees paid to insurance companyUSD $12,346
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D SPECIFIED DISEASE
Welfare Benefit Premiums Paid to CarrierUSD $227,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,384
Amount paid for insurance broker fees12346
Insurance broker organization code?3
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number21588
Policy instance 3
Insurance contract or identification number21588
Number of Individuals Covered44
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $516,696
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number21588
Policy instance 2
Insurance contract or identification number21588
Number of Individuals Covered126
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $32,598
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,019,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,598
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered332
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,837
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D SPECIFIED DISEASE
Welfare Benefit Premiums Paid to CarrierUSD $202,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6837
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number21588
Policy instance 3
Insurance contract or identification number21588
Number of Individuals Covered49
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $669,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number21588
Policy instance 2
Insurance contract or identification number21588
Number of Individuals Covered148
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $37,992
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,368,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,992
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered353
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $19,253
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D SPECIFIED DISEASE
Welfare Benefit Premiums Paid to CarrierUSD $243,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,253
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number21588
Policy instance 3
Insurance contract or identification number21588
Number of Individuals Covered52
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $611,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number21588
Policy instance 2
Insurance contract or identification number21588
Number of Individuals Covered154
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $35,572
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,273,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered373
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $18,142
Total amount of fees paid to insurance companyUSD $7,212
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D SPECIFIED DISEASE
Welfare Benefit Premiums Paid to CarrierUSD $228,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number21588
Policy instance 3
Insurance contract or identification number21588
Number of Individuals Covered161
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $25,408
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,251,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,408
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered378
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $17,627
Total amount of fees paid to insurance companyUSD $10,062
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & SPECIFIED DISEASE
Welfare Benefit Premiums Paid to CarrierUSD $218,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,627
Amount paid for insurance broker fees10062
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number21588
Policy instance 2
Insurance contract or identification number21588
Number of Individuals Covered54
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $11,436
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $563,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,436
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered401
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $15,957
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & SPECIFIED DISEASE
Welfare Benefit Premiums Paid to CarrierUSD $149,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,957
Insurance broker nameTHE BERT COMPANY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered409
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $14,852
Total amount of fees paid to insurance companyUSD $2,039
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & SPECIFIED DISEASE
Welfare Benefit Premiums Paid to CarrierUSD $132,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,568
Amount paid for insurance broker fees2039
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered436
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $10,540
Total amount of fees paid to insurance companyUSD $8,764
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D OPTIONAL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $95,444
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees8764
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $6,738
Insurance broker nameLAWLEY BENEFITS GROUP LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered397
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $9,584
Total amount of fees paid to insurance companyUSD $8,271
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $81,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,584
Insurance broker organization code?3
Amount paid for insurance broker fees8271
Additional information about fees paid to insurance brokerFEES
Insurance broker nameVERACITY BNFT DESIGNS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered336
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $9,441
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $76,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,441
Insurance broker organization code?3
Insurance broker nameVERACITY BENEFITS DESIGN
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered345
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $8,888
Total amount of fees paid to insurance companyUSD $7,430
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $69,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00411754
Policy instance 1
Insurance contract or identification number00411754
Number of Individuals Covered389
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $5,966
Total amount of fees paid to insurance companyUSD $5,119
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $47,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5119
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $5,966
Insurance broker nameVERACITY BENEFITS DESIGN

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