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BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameBREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 506

BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BREWSTER ACADEMY has sponsored the creation of one or more 401k plans.

Company Name:BREWSTER ACADEMY
Employer identification number (EIN):020223317
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062022-07-01SUSAN HARRINGTON2024-01-04
5062021-07-01SUSAN HARRINGTON2023-01-13
5062020-07-01SUSAN HARRINGTON2021-12-13

Plan Statistics for BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2022: BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01138
Total number of active participants reported on line 7a of the Form 55002022-07-01152
Number of retired or separated participants receiving benefits2022-07-011
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01153
Number of employers contributing to the scheme2022-07-010
2021: BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01142
Total number of active participants reported on line 7a of the Form 55002021-07-01150
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01150
Number of employers contributing to the scheme2021-07-010
2020: BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01100
Total number of active participants reported on line 7a of the Form 55002020-07-01142
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01142
Number of employers contributing to the scheme2020-07-010

Form 5500 Responses for BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN

2022: BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: BREWSTER ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01First time form 5500 has been submittedYes
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30058707
Policy instance 1
Insurance contract or identification number30058707
Number of Individuals Covered56
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $643
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $643
Amount paid for insurance broker fees0
Insurance broker organization code?3
NORTHEAST DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 47079 )
Policy contract number11713
Policy instance 2
Insurance contract or identification number11713
Number of Individuals Covered174
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $5,892
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,124
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BQZD
Policy instance 3
Insurance contract or identification numberGLUG0BQZD
Number of Individuals Covered151
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $6,908
Total amount of fees paid to insurance companyUSD $3,690
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $61,604
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,908
Amount paid for insurance broker fees3690
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30058707
Policy instance 1
Insurance contract or identification number30058707
Number of Individuals Covered55
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $636
Total amount of fees paid to insurance companyUSD $-1
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $636
Amount paid for insurance broker fees0
Insurance broker organization code?3
NORTHEAST DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 47079 )
Policy contract number11713
Policy instance 2
Insurance contract or identification number11713
Number of Individuals Covered176
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $5,792
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $100,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,588
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0BQZD
Policy instance 3
Insurance contract or identification numberGLTD0BQZD
Number of Individuals Covered150
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $6,976
Total amount of fees paid to insurance companyUSD $2,654
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $61,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,976
Amount paid for insurance broker fees2654
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BQZD
Policy instance 1
Insurance contract or identification numberGLUG0BQZD
Number of Individuals Covered142
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $6,633
Total amount of fees paid to insurance companyUSD $1,013
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $57,132
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,633
Amount paid for insurance broker fees1013
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3

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