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BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameBROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN
Plan identification number 501

BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

BROKEN ARROW COMMUNICATIONS, INC. has sponsored the creation of one or more 401k plans.

Company Name:BROKEN ARROW COMMUNICATIONS, INC.
Employer identification number (EIN):201285290
NAIC Classification:812990
NAIC Description:All Other Personal Services

Additional information about BROKEN ARROW COMMUNICATIONS, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2004-12-20
Company Identification Number: 0800430770
Legal Registered Office Address: 4455 ANAHEIM AVE NE

ALBUQUERQUE
United States of America (USA)
87113

More information about BROKEN ARROW COMMUNICATIONS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-08-01ALAN MIRE2022-02-15
5012019-08-01DAN FILLER2021-02-09
5012018-08-01ERIN HAIBY2019-11-05
5012017-08-01
5012016-08-01
5012015-08-01ERIN SCHAGEL
5012013-08-01ERIN SCHAGEL
5012012-08-01MARK CORDOVA
5012011-08-01MARK CORDOVA
5012009-08-01MARK CORDOVA

Plan Statistics for BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN

401k plan membership statisitcs for BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN

Measure Date Value
2020: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01234
Total number of active participants reported on line 7a of the Form 55002020-08-01246
Number of retired or separated participants receiving benefits2020-08-010
Number of other retired or separated participants entitled to future benefits2020-08-010
Total of all active and inactive participants2020-08-01246
Number of employers contributing to the scheme2020-08-010
2019: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01193
Total number of active participants reported on line 7a of the Form 55002019-08-01234
Number of retired or separated participants receiving benefits2019-08-010
Number of other retired or separated participants entitled to future benefits2019-08-010
Total of all active and inactive participants2019-08-01234
Number of employers contributing to the scheme2019-08-010
2018: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01179
Total number of active participants reported on line 7a of the Form 55002018-08-01193
Number of retired or separated participants receiving benefits2018-08-010
Number of other retired or separated participants entitled to future benefits2018-08-010
Total of all active and inactive participants2018-08-01193
Number of employers contributing to the scheme2018-08-010
2017: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01150
Total number of active participants reported on line 7a of the Form 55002017-08-01179
Number of retired or separated participants receiving benefits2017-08-010
Number of other retired or separated participants entitled to future benefits2017-08-010
Total of all active and inactive participants2017-08-01179
Number of employers contributing to the scheme2017-08-010
2016: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01374
Total number of active participants reported on line 7a of the Form 55002016-08-01150
Number of retired or separated participants receiving benefits2016-08-010
Number of other retired or separated participants entitled to future benefits2016-08-010
Total of all active and inactive participants2016-08-01150
2015: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01126
Total number of active participants reported on line 7a of the Form 55002015-08-01150
Number of retired or separated participants receiving benefits2015-08-010
Number of other retired or separated participants entitled to future benefits2015-08-010
Total of all active and inactive participants2015-08-01150
2013: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01224
Total number of active participants reported on line 7a of the Form 55002013-08-0183
Number of retired or separated participants receiving benefits2013-08-010
Number of other retired or separated participants entitled to future benefits2013-08-010
Total of all active and inactive participants2013-08-0183
2012: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01152
Total number of active participants reported on line 7a of the Form 55002012-08-01224
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-010
Total of all active and inactive participants2012-08-01224
2011: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01164
Total number of active participants reported on line 7a of the Form 55002011-08-01152
Number of retired or separated participants receiving benefits2011-08-010
Number of other retired or separated participants entitled to future benefits2011-08-010
Total of all active and inactive participants2011-08-01152
2009: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01194
Total number of active participants reported on line 7a of the Form 55002009-08-0163
Number of retired or separated participants receiving benefits2009-08-010
Number of other retired or separated participants entitled to future benefits2009-08-010
Total of all active and inactive participants2009-08-0163

Form 5500 Responses for BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN

2020: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – InsuranceYes
2019: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – InsuranceYes
2018: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – InsuranceYes
2017: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)No
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes
2015: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedNo
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)No
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – InsuranceYes
2013: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedYes
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – InsuranceYes
2011: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Submission has been amendedNo
2011-08-01This submission is the final filingNo
2011-08-01This return/report is a short plan year return/report (less than 12 months)No
2011-08-01Plan is a collectively bargained planNo
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – InsuranceYes
2009: BROKEN ARROW COMMUNICATIONS HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01Submission has been amendedNo
2009-08-01This submission is the final filingNo
2009-08-01This return/report is a short plan year return/report (less than 12 months)No
2009-08-01Plan is a collectively bargained planNo
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5958850
Policy instance 3
Insurance contract or identification number5958850
Number of Individuals Covered246
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $17,434
Total amount of fees paid to insurance companyUSD $11,588
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $151,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,434
Amount paid for insurance broker fees156
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10012861001
Policy instance 2
Insurance contract or identification number10012861001
Number of Individuals Covered161
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $1,161
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,161
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number921815
Policy instance 1
Insurance contract or identification number921815
Number of Individuals Covered109
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $37,192
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $671,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees37192
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5958850
Policy instance 3
Insurance contract or identification number5958850
Number of Individuals Covered234
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $13,722
Total amount of fees paid to insurance companyUSD $1,907
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $146,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,722
Amount paid for insurance broker fees219
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10012861001
Policy instance 2
Insurance contract or identification number10012861001
Number of Individuals Covered168
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $1,376
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,376
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number167090
Policy instance 1
Insurance contract or identification number167090
Number of Individuals Covered157
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $44,568
Total amount of fees paid to insurance companyUSD $1
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $906,935
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $44,568
Amount paid for insurance broker fees1
Additional information about fees paid to insurance brokerINDIRECT NON-MONETARY COMPENSATION
Insurance broker organization code?3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number24727
Policy instance 3
Insurance contract or identification number24727
Number of Individuals Covered94
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $17,861
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $95,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,861
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1001286
Policy instance 2
Insurance contract or identification number1001286
Number of Individuals Covered173
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $1,283
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,283
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number167090
Policy instance 1
Insurance contract or identification number167090
Number of Individuals Covered193
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $51,819
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $952,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,819
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number1600-0014
Policy instance 4
Insurance contract or identification number1600-0014
Number of Individuals Covered4
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $484
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $484
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker namePACIFIC BUSINESS SOLUTIONS, LLC
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number24727
Policy instance 3
Insurance contract or identification number24727
Number of Individuals Covered91
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $5,384
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $76,216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,384
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameHUB INTERNATIONAL INS. SVCES., INC.
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10012861001
Policy instance 2
Insurance contract or identification number10012861001
Number of Individuals Covered139
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $1,061
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,061
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameHUB INTERNATIONAL INS. SVCES., INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number167090
Policy instance 1
Insurance contract or identification number167090
Number of Individuals Covered179
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $50,776
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $941,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $40,887
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC

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