MATERNAL AND FAMILY HEALTH SERVICES has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS
401k plan membership statisitcs for A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS
Measure | Date | Value |
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2022: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2022 401k membership |
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Total participants, beginning-of-year | 2022-09-01 | 140 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-09-01 | 150 |
Number of retired or separated participants receiving benefits | 2022-09-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2022-09-01 | 0 |
Total of all active and inactive participants | 2022-09-01 | 154 |
2021: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2021 401k membership |
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Total participants, beginning-of-year | 2021-09-01 | 122 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 126 |
Number of retired or separated participants receiving benefits | 2021-09-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2021-09-01 | 0 |
Total of all active and inactive participants | 2021-09-01 | 130 |
2020: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2020 401k membership |
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Total participants, beginning-of-year | 2020-09-01 | 125 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 135 |
Total of all active and inactive participants | 2020-09-01 | 135 |
Total participants | 2020-09-01 | 135 |
2016: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2016 401k membership |
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Total participants, beginning-of-year | 2016-09-01 | 130 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 310 |
Number of retired or separated participants receiving benefits | 2016-09-01 | 4 |
Total of all active and inactive participants | 2016-09-01 | 314 |
Total participants | 2016-09-01 | 314 |
2015: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2015 401k membership |
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Total participants, beginning-of-year | 2015-09-01 | 160 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 130 |
Number of retired or separated participants receiving benefits | 2015-09-01 | 4 |
Total of all active and inactive participants | 2015-09-01 | 134 |
Total participants | 2015-09-01 | 134 |
2014: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2014 401k membership |
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Total participants, beginning-of-year | 2014-09-01 | 156 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 152 |
Number of retired or separated participants receiving benefits | 2014-09-01 | 8 |
Total of all active and inactive participants | 2014-09-01 | 160 |
Total participants | 2014-09-01 | 160 |
2013: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2013 401k membership |
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Total participants, beginning-of-year | 2013-09-01 | 194 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 175 |
Number of retired or separated participants receiving benefits | 2013-09-01 | 9 |
Number of other retired or separated participants entitled to future benefits | 2013-09-01 | 0 |
Total of all active and inactive participants | 2013-09-01 | 184 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-09-01 | 0 |
Total participants | 2013-09-01 | 184 |
Number of participants with account balances | 2013-09-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-09-01 | 0 |
2012: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2012 401k membership |
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Total participants, beginning-of-year | 2012-09-01 | 174 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 185 |
Number of retired or separated participants receiving benefits | 2012-09-01 | 9 |
Number of other retired or separated participants entitled to future benefits | 2012-09-01 | 0 |
Total of all active and inactive participants | 2012-09-01 | 194 |
Total participants | 2012-09-01 | 194 |
2011: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2011 401k membership |
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Total participants, beginning-of-year | 2011-09-01 | 170 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 165 |
Number of retired or separated participants receiving benefits | 2011-09-01 | 9 |
Number of other retired or separated participants entitled to future benefits | 2011-09-01 | 0 |
Total of all active and inactive participants | 2011-09-01 | 174 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-09-01 | 0 |
Total participants | 2011-09-01 | 174 |
Number of participants with account balances | 2011-09-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-09-01 | 0 |
2009: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2009 401k membership |
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Total participants, beginning-of-year | 2009-09-01 | 147 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 190 |
Number of retired or separated participants receiving benefits | 2009-09-01 | 9 |
Number of other retired or separated participants entitled to future benefits | 2009-09-01 | 0 |
Total of all active and inactive participants | 2009-09-01 | 199 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-09-01 | 0 |
Total participants | 2009-09-01 | 199 |
Number of participants with account balances | 2009-09-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-09-01 | 0 |
Number of employers contributing to the scheme | 2009-09-01 | 0 |
2022: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2022 form 5500 responses |
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2022-09-01 | Type of plan entity | Single employer plan |
2022-09-01 | Submission has been amended | No |
2022-09-01 | This submission is the final filing | No |
2022-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-09-01 | Plan is a collectively bargained plan | No |
2022-09-01 | Plan funding arrangement – Insurance | Yes |
2022-09-01 | Plan benefit arrangement – Insurance | Yes |
2021: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2021 form 5500 responses |
---|
2021-09-01 | Type of plan entity | Single employer plan |
2021-09-01 | Submission has been amended | No |
2021-09-01 | This submission is the final filing | No |
2021-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-09-01 | Plan is a collectively bargained plan | No |
2021-09-01 | Plan funding arrangement – Insurance | Yes |
2021-09-01 | Plan benefit arrangement – Insurance | Yes |
2020: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2020 form 5500 responses |
---|
2020-09-01 | Type of plan entity | Single employer plan |
2020-09-01 | Submission has been amended | No |
2020-09-01 | This submission is the final filing | No |
2020-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-09-01 | Plan is a collectively bargained plan | No |
2020-09-01 | Plan funding arrangement – Insurance | Yes |
2020-09-01 | Plan benefit arrangement – Insurance | Yes |
2016: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2016 form 5500 responses |
---|
2016-09-01 | Type of plan entity | Single employer plan |
2016-09-01 | Submission has been amended | No |
2016-09-01 | This submission is the final filing | No |
2016-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-09-01 | Plan is a collectively bargained plan | No |
2016-09-01 | Plan funding arrangement – Insurance | Yes |
2016-09-01 | Plan benefit arrangement – Insurance | Yes |
2015: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2015 form 5500 responses |
---|
2015-09-01 | Type of plan entity | Single employer plan |
2015-09-01 | Submission has been amended | No |
2015-09-01 | This submission is the final filing | No |
2015-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-09-01 | Plan is a collectively bargained plan | No |
2015-09-01 | Plan funding arrangement – Insurance | Yes |
2015-09-01 | Plan benefit arrangement – Insurance | Yes |
2014: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2014 form 5500 responses |
---|
2014-09-01 | Type of plan entity | Single employer plan |
2014-09-01 | Submission has been amended | No |
2014-09-01 | This submission is the final filing | No |
2014-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-09-01 | Plan is a collectively bargained plan | No |
2014-09-01 | Plan funding arrangement – Insurance | Yes |
2014-09-01 | Plan benefit arrangement – Insurance | Yes |
2013: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2013 form 5500 responses |
---|
2013-09-01 | Type of plan entity | Single employer plan |
2013-09-01 | Submission has been amended | No |
2013-09-01 | This submission is the final filing | No |
2013-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-09-01 | Plan is a collectively bargained plan | No |
2013-09-01 | Plan funding arrangement – Insurance | Yes |
2013-09-01 | Plan benefit arrangement – Insurance | Yes |
2012: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2012 form 5500 responses |
---|
2012-09-01 | Type of plan entity | Single employer plan |
2012-09-01 | Submission has been amended | No |
2012-09-01 | This submission is the final filing | No |
2012-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-09-01 | Plan is a collectively bargained plan | No |
2012-09-01 | Plan funding arrangement – Insurance | Yes |
2012-09-01 | Plan benefit arrangement – Insurance | Yes |
2011: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2011 form 5500 responses |
---|
2011-09-01 | Type of plan entity | Single employer plan |
2011-09-01 | Submission has been amended | No |
2011-09-01 | This submission is the final filing | No |
2011-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-09-01 | Plan is a collectively bargained plan | No |
2011-09-01 | Plan funding arrangement – Insurance | Yes |
2011-09-01 | Plan benefit arrangement – Insurance | Yes |
2009: A PROGRAM OF PREPAID MAJOR MEDICAL PROTECTION FOR EMPLOYEES OF MFHS 2009 form 5500 responses |
---|
2009-09-01 | Type of plan entity | Single employer plan |
2009-09-01 | Submission has been amended | No |
2009-09-01 | This submission is the final filing | No |
2009-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-09-01 | Plan is a collectively bargained plan | No |
2009-09-01 | Plan funding arrangement – Insurance | Yes |
2009-09-01 | Plan benefit arrangement – Insurance | Yes |
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 116734 |
Policy instance | 4 |
Insurance contract or identification number | 116734 | Number of Individuals Covered | 25 | Insurance policy start date | 2022-09-01 | Insurance policy end date | 2023-08-31 | 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 $175,788 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 116734 |
Policy instance | 3 |
Insurance contract or identification number | 116734 | Number of Individuals Covered | 330 | Insurance policy start date | 2022-09-01 | Insurance policy end date | 2023-08-31 | 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 | Yes | 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 $16,833 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 116734 |
Policy instance | 2 |
Insurance contract or identification number | 116734 | Number of Individuals Covered | 309 | Insurance policy start date | 2022-09-01 | Insurance policy end date | 2023-08-31 | Total amount of commissions paid to insurance broker | USD $64,207 | Total amount of fees paid to insurance company | USD $0 | 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 $2,188,404 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52,789 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00575707 |
Policy instance | 1 |
Insurance contract or identification number | 00575707 | Number of Individuals Covered | 168 | Insurance policy start date | 2022-09-01 | Insurance policy end date | 2023-08-31 | Total amount of commissions paid to insurance broker | USD $8,964 | Total amount of fees paid to insurance company | USD $3,652 | 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 | Yes | 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 $107,138 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,964 | Amount paid for insurance broker fees | 3652 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00575707 |
Policy instance | 1 |
Insurance contract or identification number | 00575707 | Number of Individuals Covered | 147 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | Total amount of commissions paid to insurance broker | USD $7,169 | Total amount of fees paid to insurance company | USD $2,516 | 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 | Yes | 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 $89,987 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,169 | Amount paid for insurance broker fees | 2516 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 116734 |
Policy instance | 2 |
Insurance contract or identification number | 116734 | Number of Individuals Covered | 271 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | Total amount of commissions paid to insurance broker | USD $53,263 | Total amount of fees paid to insurance company | USD $0 | 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 $1,788,564 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $53,263 | Insurance broker organization code? | 3 |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 116734 |
Policy instance | 3 |
Insurance contract or identification number | 116734 | Number of Individuals Covered | 290 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | 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 | Yes | 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 $15,682 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 116734 |
Policy instance | 4 |
Insurance contract or identification number | 116734 | Number of Individuals Covered | 30 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | 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 $175,291 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 116734 |
Policy instance | 2 |
Insurance contract or identification number | 116734 | Number of Individuals Covered | 125 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $50,266 | Total amount of fees paid to insurance company | USD $0 | 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 | Yes | 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 $1,773,400 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $50,266 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00575707 |
Policy instance | 1 |
Insurance contract or identification number | 00575707 | Number of Individuals Covered | 135 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $5,294 | Total amount of fees paid to insurance company | USD $0 | 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 | Yes | 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 $85,296 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,840 |
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BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 60147 ) |
Policy contract number | 052247 |
Policy instance | 1 |
Insurance contract or identification number | 052247 | Number of Individuals Covered | 334 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | Insurance broker name | NONE |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 012276 |
Policy instance | 2 |
Insurance contract or identification number | 012276 | Number of Individuals Covered | 397 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | Yes | 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 $19,345 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker name | NONE |
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BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 60147 ) |
Policy contract number | 052247 |
Policy instance | 1 |
Insurance contract or identification number | 052247 | Number of Individuals Covered | 341 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | Insurance broker name | NONE |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 012276 |
Policy instance | 2 |
Insurance contract or identification number | 012276 | Number of Individuals Covered | 407 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | Yes | 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 $19,545 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker name | NONE |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 012276 |
Policy instance | 2 |
Insurance contract or identification number | 012276 | Number of Individuals Covered | 185 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,655 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker name | NONE |
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BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 60147 ) |
Policy contract number | 052247 |
Policy instance | 1 |
Insurance contract or identification number | 052247 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | 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 | Insurance broker name | NONE |
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BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 60147 ) |
Policy contract number | 052247 |
Policy instance | 1 |
Insurance contract or identification number | 052247 | Number of Individuals Covered | 165 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Health Insurance Welfare Benefit | Yes | 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 |
|
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 012276 |
Policy instance | 2 |
Insurance contract or identification number | 012276 | Number of Individuals Covered | 193 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,394 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 60147 ) |
Policy contract number | 052247 |
Policy instance | 1 |
Insurance contract or identification number | 052247 | Number of Individuals Covered | 166 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | 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 |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 012276 |
Policy instance | 2 |
Insurance contract or identification number | 012276 | Number of Individuals Covered | 203 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,935 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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