401k Plan data: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY plan

HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 401k Plan overview

Plan Name	HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY
Plan identification number	504

HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. has sponsored the creation of one or more 401k plans.

Company Name: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC.

Employer identification number (EIN): 042466767

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2015-01-01 JANIS SANTOS
504 2015-01-01 NICOLE BLAIS 2022-11-03
504 2014-01-01 JANIS SANTOS
504 2013-01-01 JENNIFER C CHARTIER
504 2012-01-01 JENNIFER C CHARTIER
504 2011-01-01 JENNIFER C CHARTIER
504 2009-01-01 DALE BRENNAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
504	2015-01-01	JANIS SANTOS
504	2015-01-01	NICOLE BLAIS	2022-11-03
504	2014-01-01	JANIS SANTOS
504	2013-01-01	JENNIFER C CHARTIER
504	2012-01-01	JENNIFER C CHARTIER
504	2011-01-01	JENNIFER C CHARTIER
504	2009-01-01	DALE BRENNAN

Plan Statistics for HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY

401k plan membership statisitcs for HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY

Measure Date Value
2015: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2015 401k membership
Total participants, beginning-of-year 2015-01-01 271
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 290
Total of all active and inactive participants 2015-01-01 290
Total participants 2015-01-01 290
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Number of employers contributing to the scheme 2015-01-01 0
2014: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2014 401k membership
Total participants, beginning-of-year 2014-01-01 276
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 271
Total of all active and inactive participants 2014-01-01 271
Total participants 2014-01-01 271
2013: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2013 401k membership
Total participants, beginning-of-year 2013-01-01 294
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 276
Total of all active and inactive participants 2013-01-01 276
Total participants 2013-01-01 276
2012: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2012 401k membership
Total participants, beginning-of-year 2012-01-01 285
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 294
Total of all active and inactive participants 2012-01-01 294
Total participants 2012-01-01 294
2011: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2011 401k membership
Total participants, beginning-of-year 2011-01-01 277
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 285
Total of all active and inactive participants 2011-01-01 285
Total participants 2011-01-01 285
2009: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2009 401k membership
Total participants, beginning-of-year 2009-01-01 286
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 286
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 286
Total participants 2009-01-01 286
Number of employers contributing to the scheme 2009-01-01 1

Measure	Date	Value
2015: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2015 401k membership
Total participants, beginning-of-year	2015-01-01	271
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	290
Total of all active and inactive participants	2015-01-01	290
Total participants	2015-01-01	290
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Number of employers contributing to the scheme	2015-01-01	0
2014: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2014 401k membership
Total participants, beginning-of-year	2014-01-01	276
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	271
Total of all active and inactive participants	2014-01-01	271
Total participants	2014-01-01	271
2013: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2013 401k membership
Total participants, beginning-of-year	2013-01-01	294
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	276
Total of all active and inactive participants	2013-01-01	276
Total participants	2013-01-01	276
2012: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2012 401k membership
Total participants, beginning-of-year	2012-01-01	285
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	294
Total of all active and inactive participants	2012-01-01	294
Total participants	2012-01-01	294
2011: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2011 401k membership
Total participants, beginning-of-year	2011-01-01	277
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	285
Total of all active and inactive participants	2011-01-01	285
Total participants	2011-01-01	285
2009: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2009 401k membership
Total participants, beginning-of-year	2009-01-01	286
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	286
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	286
Total participants	2009-01-01	286
Number of employers contributing to the scheme	2009-01-01	1

Form 5500 Responses for HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY

2015: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC. ANCILLARY 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

299902

Policy instance

Insurance contract or identification number	299902
Number of Individuals Covered	290
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $9,580
Total amount of fees paid to insurance company	USD $1,144
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Welfare Benefit Premiums Paid to Carrier	USD $111,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,580
Amount paid for insurance broker fees	1144
Additional information about fees paid to insurance broker	SERVICE AND ADMINISTRATION
Insurance broker organization code?	3

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Company Name:	HOLYOKE CHICOPEE SPRINGFIELD HEAD START, INC.
Employer identification number (EIN):	042466767
NAIC Classification:	624100
NAIC Description:	Individual and Family Services