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THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN 401k Plan overview

Plan NameTHE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN
Plan identification number 502

THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

THE GILL ST. BERNARD'S SCHOOL has sponsored the creation of one or more 401k plans.

Company Name:THE GILL ST. BERNARD'S SCHOOL
Employer identification number (EIN):221964930
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-09-01
5022020-09-01

Plan Statistics for THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN

401k plan membership statisitcs for THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN

Measure Date Value
2021: THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01123
Total number of active participants reported on line 7a of the Form 55002021-09-01127
Total of all active and inactive participants2021-09-01127
2020: THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01123
Total number of active participants reported on line 7a of the Form 55002020-09-01123
Total of all active and inactive participants2020-09-01123

Form 5500 Responses for THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN

2021: THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: THE GILL ST. BERNARD'S SCHOOL MEDICAL AND DENTAL INSURANCE PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01First time form 5500 has been submittedYes
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number84871
Policy instance 1
Insurance contract or identification number84871
Number of Individuals Covered123
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $64,783
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,070,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64,783
Insurance broker organization code?3
DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 )
Policy contract number07528
Policy instance 2
Insurance contract or identification number07528
Number of Individuals Covered127
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $7,957
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,957
Insurance broker organization code?3
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number84871
Policy instance 1
Insurance contract or identification number84871
Number of Individuals Covered123
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $61,596
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,965,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,596
Insurance broker organization code?3
DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 )
Policy contract number07528
Policy instance 2
Insurance contract or identification number07528
Number of Individuals Covered123
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $7,429
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,429
Insurance broker organization code?3

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