401k Plan data: LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN plan

LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN 401k Plan overview

Plan Name	LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN
Plan identification number	501

LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Long-term disability 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

LINCOLN ACADEMY 403(B) RETIREMENT PLAN has sponsored the creation of one or more 401k plans.

Company Name: LINCOLN ACADEMY 403(B) RETIREMENT PLAN

Employer identification number (EIN): 010219126

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2018-07-01 WENDY CORLETT 2020-01-29
501 2018-07-01 WENDY CORLETT 2020-11-03

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2018-07-01	WENDY CORLETT	2020-01-29
501	2018-07-01	WENDY CORLETT	2020-11-03

Plan Statistics for LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN

401k plan membership statisitcs for LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN

Measure Date Value
2018: LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 100
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 100
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 0
Total of all active and inactive participants 2018-07-01 100
Number of employers contributing to the scheme 2018-07-01 0

Measure	Date	Value
2018: LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	100
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	100
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	0
Total of all active and inactive participants	2018-07-01	100
Number of employers contributing to the scheme	2018-07-01	0

Form 5500 Responses for LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN

2018: LINCOLN ACADEMY FLEXIBLE BENEFITS PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	First time form 5500 has been submitted	Yes
2018-07-01	Submission has been amended	Yes
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

39244

Policy instance

Insurance contract or identification number	39244
Number of Individuals Covered	99
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $2,988
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,988
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )

Policy contract number

62189

Policy instance

Insurance contract or identification number	62189
Number of Individuals Covered	149
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $3,422
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $58,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,909
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 )

Policy contract number

222008

Policy instance

Insurance contract or identification number	222008
Number of Individuals Covered	132
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $477
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $477
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 )

Policy contract number

83728

Policy instance

Insurance contract or identification number	83728
Number of Individuals Covered	100
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
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

Potentially related plans

LINCOLN ACADEMY 401(K) PLAN TRUST [EIN = 202344918]

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Company Name:	LINCOLN ACADEMY 403(B) RETIREMENT PLAN
Employer identification number (EIN):	010219126
NAIC Classification:	611000