401k Plan data: CANTERBURY SCHOOL HDE plan

CANTERBURY SCHOOL HDE 401k Plan overview

Plan Name	CANTERBURY SCHOOL HDE
Plan identification number	501

CANTERBURY SCHOOL HDE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover 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.

401k Sponsoring company profile

CANTERBURY SCHOOL has sponsored the creation of one or more 401k plans.

Company Name: CANTERBURY SCHOOL

Employer identification number (EIN): 351410931

NAIC Classification: 611000

Additional information about CANTERBURY SCHOOL

Jurisdiction of Incorporation: North Carolina Secretary of State

Incorporation Date:

Company Identification Number: 0294843

More information about CANTERBURY SCHOOL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CANTERBURY SCHOOL HDE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-06-01 JERRY BELCHER 2023-03-14
501 2020-06-01 JERRY BELCHER 2022-03-04
501 2019-06-01 JERRY BELCHER 2020-08-26
501 2018-06-01 JERRY BELCHER 2020-03-05
501 2017-06-01
501 2016-06-01
501 2015-06-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2021-06-01	JERRY BELCHER	2023-03-14
501	2020-06-01	JERRY BELCHER	2022-03-04
501	2019-06-01	JERRY BELCHER	2020-08-26
501	2018-06-01	JERRY BELCHER	2020-03-05
501	2017-06-01
501	2016-06-01
501	2015-06-01

Plan Statistics for CANTERBURY SCHOOL HDE

401k plan membership statisitcs for CANTERBURY SCHOOL HDE

Measure Date Value
2021: CANTERBURY SCHOOL HDE 2021 401k membership
Total participants, beginning-of-year 2021-06-01 96
Total number of active participants reported on line 7a of the Form 5500 2021-06-01 94
Number of retired or separated participants receiving benefits 2021-06-01 1
Number of other retired or separated participants entitled to future benefits 2021-06-01 5
Total of all active and inactive participants 2021-06-01 100
Total participants 2021-06-01 100
2020: CANTERBURY SCHOOL HDE 2020 401k membership
Total participants, beginning-of-year 2020-06-01 99
Total number of active participants reported on line 7a of the Form 5500 2020-06-01 96
Number of retired or separated participants receiving benefits 2020-06-01 4
Number of other retired or separated participants entitled to future benefits 2020-06-01 15
Total of all active and inactive participants 2020-06-01 115
Total participants 2020-06-01 115
2019: CANTERBURY SCHOOL HDE 2019 401k membership
Total participants, beginning-of-year 2019-06-01 100
Total number of active participants reported on line 7a of the Form 5500 2019-06-01 99
Number of retired or separated participants receiving benefits 2019-06-01 1
Total of all active and inactive participants 2019-06-01 100
Total participants 2019-06-01 100
2018: CANTERBURY SCHOOL HDE 2018 401k membership
Total participants, beginning-of-year 2018-06-01 100
Total number of active participants reported on line 7a of the Form 5500 2018-06-01 102
Number of retired or separated participants receiving benefits 2018-06-01 2
Number of other retired or separated participants entitled to future benefits 2018-06-01 2
Total of all active and inactive participants 2018-06-01 106
Total participants 2018-06-01 106
2017: CANTERBURY SCHOOL HDE 2017 401k membership
Total participants, beginning-of-year 2017-06-01 104
Total number of active participants reported on line 7a of the Form 5500 2017-06-01 102
Number of retired or separated participants receiving benefits 2017-06-01 2
Number of other retired or separated participants entitled to future benefits 2017-06-01 3
Total of all active and inactive participants 2017-06-01 107
Total participants 2017-06-01 107
2016: CANTERBURY SCHOOL HDE 2016 401k membership
Total participants, beginning-of-year 2016-06-01 103
Total number of active participants reported on line 7a of the Form 5500 2016-06-01 103
Number of retired or separated participants receiving benefits 2016-06-01 2
Number of other retired or separated participants entitled to future benefits 2016-06-01 1
Total of all active and inactive participants 2016-06-01 106
Total participants 2016-06-01 106
2015: CANTERBURY SCHOOL HDE 2015 401k membership
Total participants, beginning-of-year 2015-06-01 103
Total number of active participants reported on line 7a of the Form 5500 2015-06-01 102
Number of retired or separated participants receiving benefits 2015-06-01 1
Total of all active and inactive participants 2015-06-01 103
Total participants 2015-06-01 103

Measure	Date	Value
2021: CANTERBURY SCHOOL HDE 2021 401k membership
Total participants, beginning-of-year	2021-06-01	96
Total number of active participants reported on line 7a of the Form 5500	2021-06-01	94
Number of retired or separated participants receiving benefits	2021-06-01	1
Number of other retired or separated participants entitled to future benefits	2021-06-01	5
Total of all active and inactive participants	2021-06-01	100
Total participants	2021-06-01	100
2020: CANTERBURY SCHOOL HDE 2020 401k membership
Total participants, beginning-of-year	2020-06-01	99
Total number of active participants reported on line 7a of the Form 5500	2020-06-01	96
Number of retired or separated participants receiving benefits	2020-06-01	4
Number of other retired or separated participants entitled to future benefits	2020-06-01	15
Total of all active and inactive participants	2020-06-01	115
Total participants	2020-06-01	115
2019: CANTERBURY SCHOOL HDE 2019 401k membership
Total participants, beginning-of-year	2019-06-01	100
Total number of active participants reported on line 7a of the Form 5500	2019-06-01	99
Number of retired or separated participants receiving benefits	2019-06-01	1
Total of all active and inactive participants	2019-06-01	100
Total participants	2019-06-01	100
2018: CANTERBURY SCHOOL HDE 2018 401k membership
Total participants, beginning-of-year	2018-06-01	100
Total number of active participants reported on line 7a of the Form 5500	2018-06-01	102
Number of retired or separated participants receiving benefits	2018-06-01	2
Number of other retired or separated participants entitled to future benefits	2018-06-01	2
Total of all active and inactive participants	2018-06-01	106
Total participants	2018-06-01	106
2017: CANTERBURY SCHOOL HDE 2017 401k membership
Total participants, beginning-of-year	2017-06-01	104
Total number of active participants reported on line 7a of the Form 5500	2017-06-01	102
Number of retired or separated participants receiving benefits	2017-06-01	2
Number of other retired or separated participants entitled to future benefits	2017-06-01	3
Total of all active and inactive participants	2017-06-01	107
Total participants	2017-06-01	107
2016: CANTERBURY SCHOOL HDE 2016 401k membership
Total participants, beginning-of-year	2016-06-01	103
Total number of active participants reported on line 7a of the Form 5500	2016-06-01	103
Number of retired or separated participants receiving benefits	2016-06-01	2
Number of other retired or separated participants entitled to future benefits	2016-06-01	1
Total of all active and inactive participants	2016-06-01	106
Total participants	2016-06-01	106
2015: CANTERBURY SCHOOL HDE 2015 401k membership
Total participants, beginning-of-year	2015-06-01	103
Total number of active participants reported on line 7a of the Form 5500	2015-06-01	102
Number of retired or separated participants receiving benefits	2015-06-01	1
Total of all active and inactive participants	2015-06-01	103
Total participants	2015-06-01	103

Form 5500 Responses for CANTERBURY SCHOOL HDE

2021: CANTERBURY SCHOOL HDE 2021 form 5500 responses
2021-06-01	Type of plan entity	Single employer plan
2021-06-01	Plan funding arrangement – Insurance	Yes
2021-06-01	Plan benefit arrangement – Insurance	Yes
2020: CANTERBURY SCHOOL HDE 2020 form 5500 responses
2020-06-01	Type of plan entity	Single employer plan
2020-06-01	Plan funding arrangement – Insurance	Yes
2020-06-01	Plan benefit arrangement – Insurance	Yes
2019: CANTERBURY SCHOOL HDE 2019 form 5500 responses
2019-06-01	Type of plan entity	Single employer plan
2019-06-01	Plan funding arrangement – Insurance	Yes
2019-06-01	Plan benefit arrangement – Insurance	Yes
2018: CANTERBURY SCHOOL HDE 2018 form 5500 responses
2018-06-01	Type of plan entity	Single employer plan
2018-06-01	Plan funding arrangement – Insurance	Yes
2018-06-01	Plan benefit arrangement – Insurance	Yes
2017: CANTERBURY SCHOOL HDE 2017 form 5500 responses
2017-06-01	Type of plan entity	Single employer plan
2017-06-01	Plan funding arrangement – Insurance	Yes
2017-06-01	Plan benefit arrangement – Insurance	Yes
2016: CANTERBURY SCHOOL HDE 2016 form 5500 responses
2016-06-01	Type of plan entity	Single employer plan
2016-06-01	Plan funding arrangement – Insurance	Yes
2016-06-01	Plan benefit arrangement – Insurance	Yes
2015: CANTERBURY SCHOOL HDE 2015 form 5500 responses
2015-06-01	Type of plan entity	Single employer plan
2015-06-01	First time form 5500 has been submitted	Yes
2015-06-01	Plan funding arrangement – Insurance	Yes
2015-06-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE NORTH RIVER INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 21105 )

Policy contract number

NR310010

Policy instance

Insurance contract or identification number	NR310010
Number of Individuals Covered	96
Insurance policy start date	2020-06-01
Insurance policy end date	2021-05-31
Total amount of commissions paid to insurance broker	USD $30,016
Total amount of fees paid to insurance company	USD $24,129
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $264,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $30,016
Insurance broker organization code?	3
Amount paid for insurance broker fees	24129
Additional information about fees paid to insurance broker	FEES

UNITED HEALTHCARE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 52411 )

Policy contract number

100063

Policy instance

Insurance contract or identification number	100063
Number of Individuals Covered	96
Insurance policy start date	2020-06-01
Insurance policy end date	2021-05-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,863
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )

Policy contract number

US1181768

Policy instance

Insurance contract or identification number	US1181768
Number of Individuals Covered	99
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $29,579
Total amount of fees paid to insurance company	USD $24,885
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $260,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,579
Insurance broker organization code?	3
Amount paid for insurance broker fees	24885
Additional information about fees paid to insurance broker	FEES

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30067851

Policy instance

Insurance contract or identification number	30067851
Number of Individuals Covered	49
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $644
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $644
Insurance broker organization code?	3

UNITED HEALTHCARE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 52411 )

Policy contract number

100063

Policy instance

Insurance contract or identification number	100063
Number of Individuals Covered	99
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $778
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $778
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL143059

Policy instance

Insurance contract or identification number	GL143059
Number of Individuals Covered	121
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $1,098
Total amount of fees paid to insurance company	USD $114
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $7,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,098
Amount paid for insurance broker fees	114
Additional information about fees paid to insurance broker	OTHER FEES
Insurance broker organization code?	3

US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )

Policy contract number

US567103

Policy instance

Insurance contract or identification number	US567103
Number of Individuals Covered	104
Insurance policy start date	2018-06-01
Insurance policy end date	2019-05-31
Total amount of commissions paid to insurance broker	USD $28,474
Total amount of fees paid to insurance company	USD $24,580
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $250,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $28,474
Additional information about fees paid to insurance broker	COMMISSIONS PAID
Insurance broker organization code?	3
Amount paid for insurance broker fees	24580

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30067851

Policy instance

Insurance contract or identification number	30067851
Number of Individuals Covered	49
Insurance policy start date	2018-06-01
Insurance policy end date	2019-05-31
Total amount of commissions paid to insurance broker	USD $643
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $643
Additional information about fees paid to insurance broker	COMMISSIONS PAID
Insurance broker organization code?	3

UNITED HEALTHCARE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 52411 )

Policy contract number

100063

Policy instance

Insurance contract or identification number	100063
Number of Individuals Covered	104
Insurance policy start date	2018-06-01
Insurance policy end date	2019-05-31
Total amount of commissions paid to insurance broker	USD $815
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $815
Additional information about fees paid to insurance broker	COMMISSIONS PAID
Insurance broker organization code?	3

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL19829

Policy instance

Insurance contract or identification number	HCL19829
Number of Individuals Covered	104
Insurance policy start date	2017-06-01
Insurance policy end date	2018-05-30
Total amount of commissions paid to insurance broker	USD $39,371
Total amount of fees paid to insurance company	USD $34,937
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $347,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PHP MANAGEMENT SYSTEMS, INC. (National Association of Insurance Commissioners NAIC id number: 12331 )

Policy contract number

S257-16

Policy instance

Insurance contract or identification number	S257-16
Number of Individuals Covered	103
Insurance policy start date	2015-06-01
Insurance policy end date	2016-05-31
Total amount of fees paid to insurance company	USD $81,917
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $291,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	34001
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	ONI RISK PARTNERS INC.

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Company Name:	CANTERBURY SCHOOL
Employer identification number (EIN):	351410931
NAIC Classification:	611000

Jurisdiction of Incorporation:	North Carolina Secretary of State
Incorporation Date:
Company Identification Number:	0294843