BD OF TRUSTEES UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGR has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN
401k plan membership statisitcs for UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN
| Measure | Date | Value |
|---|
| 2022: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 709 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 525 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 179 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 7 |
| Total of all active and inactive participants | 2022-01-01 | 711 |
| 2021: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 799 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 521 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 179 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 9 |
| Total of all active and inactive participants | 2021-01-01 | 709 |
| 2020: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 705 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 527 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 258 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 14 |
| Total of all active and inactive participants | 2020-01-01 | 799 |
| 2019: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 663 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 509 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 183 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 13 |
| Total of all active and inactive participants | 2019-01-01 | 705 |
| 2018: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 649 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 488 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 164 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 11 |
| Total of all active and inactive participants | 2018-01-01 | 663 |
| 2017: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 650 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 476 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 162 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 11 |
| Total of all active and inactive participants | 2017-01-01 | 649 |
| 2016: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 632 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 486 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 153 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 11 |
| Total of all active and inactive participants | 2016-01-01 | 650 |
| 2015: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 590 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 475 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 147 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 10 |
| Total of all active and inactive participants | 2015-01-01 | 632 |
| 2014: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 562 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 439 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 142 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 9 |
| Total of all active and inactive participants | 2014-01-01 | 590 |
| 2013: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 559 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 416 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 136 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 10 |
| Total of all active and inactive participants | 2013-01-01 | 562 |
| 2012: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 544 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 417 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 134 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 8 |
| Total of all active and inactive participants | 2012-01-01 | 559 |
| 2011: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 547 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 403 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 133 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 8 |
| Total of all active and inactive participants | 2011-01-01 | 544 |
| 2010: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 553 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 432 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 107 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 8 |
| Total of all active and inactive participants | 2010-01-01 | 547 |
| 2009: UFT AND UFT WELFARE FUND EMPLOYEE HEALTH BENEFITS PROGRAM PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 543 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 439 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 106 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 8 |
| Total of all active and inactive participants | 2009-01-01 | 553 |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 164791 |
| Policy instance | 2 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | 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 $1,076,896 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEMHEALTH (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 11023071002 |
| Policy instance | 1 |
| Insurance contract or identification number | 11023071002 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 $263,780 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US-008041-0010 |
| Policy instance | 9 |
| Insurance contract or identification number | US-008041-0010 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 $15,446 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | 164791 |
| Policy instance | 3 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 1075 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | 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 $11,397,164 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 11023071003 |
| Policy instance | 4 |
| Insurance contract or identification number | 11023071003 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 $140,391 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 11023071001 |
| Policy instance | 5 |
| Insurance contract or identification number | 11023071001 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 $1,418,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 100000082 |
| Policy instance | 6 |
| Insurance contract or identification number | 100000082 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 $131,902 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | Y00002883 |
| Policy instance | 7 |
| Insurance contract or identification number | Y00002883 | | Number of Individuals Covered | 85 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 $697,480 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307003 |
| Policy instance | 8 |
| Insurance contract or identification number | 1102307003 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 $324,165 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | 164791 |
| Policy instance | 3 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 1072 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | 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 $11,933,321 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 164791 |
| Policy instance | 2 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 93 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | 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 $1,106,604 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEMHEALTH (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1000008200 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000008200 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 $180,441 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102303000 |
| Policy instance | 6 |
| Insurance contract or identification number | 1102303000 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 $305,288 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307001 |
| Policy instance | 4 |
| Insurance contract or identification number | 1102307001 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 $1,542,722 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307002 |
| Policy instance | 5 |
| Insurance contract or identification number | 1102307002 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 $269,702 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | Y00002883 |
| Policy instance | 7 |
| Insurance contract or identification number | Y00002883 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 $2,534,611 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307003 |
| Policy instance | 8 |
| Insurance contract or identification number | 1102307003 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 $123,667 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US-008041-0010 |
| Policy instance | 9 |
| Insurance contract or identification number | US-008041-0010 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 164791 |
| Policy instance | 2 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | 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 $857,052 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | 164791 |
| Policy instance | 3 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 1044 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | 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 $10,081,919 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307001 |
| Policy instance | 4 |
| Insurance contract or identification number | 1102307001 | | Number of Individuals Covered | 314 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 $1,328,415 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307002 |
| Policy instance | 5 |
| Insurance contract or identification number | 1102307002 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 $293,570 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102303 |
| Policy instance | 6 |
| Insurance contract or identification number | 1102303 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 $252,918 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307003 |
| Policy instance | 8 |
| Insurance contract or identification number | 1102307003 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 $21,948 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US-008041-0010 |
| Policy instance | 9 |
| Insurance contract or identification number | US-008041-0010 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 $9,629 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEMHEALTH (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1000008200 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000008200 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 $174,138 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | Y00002883 |
| Policy instance | 7 |
| Insurance contract or identification number | Y00002883 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 $400,697 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307001 |
| Policy instance | 4 |
| Insurance contract or identification number | 1102307001 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 $1,220,482 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEMHEALTH (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1000008200 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000008200 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 $162,013 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 164791 |
| Policy instance | 2 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | 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 $768,470 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | 164791 |
| Policy instance | 3 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 969 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | 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 $7,591,255 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 11023071002 |
| Policy instance | 5 |
| Insurance contract or identification number | 11023071002 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 $193,022 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEMHEALTH (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102303000 |
| Policy instance | 6 |
| Insurance contract or identification number | 1102303000 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 $216,337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | Y00002883 |
| Policy instance | 7 |
| Insurance contract or identification number | Y00002883 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 $1,344,036 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1004225000 |
| Policy instance | 4 |
| Insurance contract or identification number | 1004225000 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-06-30 | | 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 $559,046 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307002 |
| Policy instance | 10 |
| Insurance contract or identification number | 1102307002 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2018-12-31 | | 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 $86,323 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | 164791 |
| Policy instance | 8 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 859 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | 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 $8,344,982 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102307001 |
| Policy instance | 9 |
| Insurance contract or identification number | 1102307001 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2018-12-31 | | 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 $580,123 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 164791 |
| Policy instance | 7 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 83 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | 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 $779,201 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1004225001 |
| Policy instance | 5 |
| Insurance contract or identification number | 1004225001 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-06-30 | | 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 $48,423 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEMHEALTH (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1004984000 |
| Policy instance | 6 |
| Insurance contract or identification number | 1004984000 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 $123,976 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEMHEALTH (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1102303000 |
| Policy instance | 11 |
| Insurance contract or identification number | 1102303000 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 $103,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEMHEALTH (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1004012000 |
| Policy instance | 3 |
| Insurance contract or identification number | 1004012000 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-06-30 | | 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 $87,520 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | Y00002883 |
| Policy instance | 2 |
| Insurance contract or identification number | Y00002883 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 $630,434 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US-008041-0010 |
| Policy instance | 1 |
| Insurance contract or identification number | US-008041-0010 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 $26,202 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | Y00002883 |
| Policy instance | 2 |
| Insurance contract or identification number | Y00002883 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 $793,665 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1004012000 |
| Policy instance | 3 |
| Insurance contract or identification number | 1004012000 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 $181,522 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1004012001 |
| Policy instance | 4 |
| Insurance contract or identification number | 1004012001 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 $6,577 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1004225000 |
| Policy instance | 5 |
| Insurance contract or identification number | 1004225000 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 $1,123,066 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1004225001 |
| Policy instance | 6 |
| Insurance contract or identification number | 1004225001 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 $169,253 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US-008041-0010 |
| Policy instance | 1 |
| Insurance contract or identification number | US-008041-0010 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 $2,290 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 164791 |
| Policy instance | 8 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 83 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | 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 $654,818 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | 164791 |
| Policy instance | 9 |
| Insurance contract or identification number | 164791 | | Number of Individuals Covered | 839 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | 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 $6,340,931 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1004984000 |
| Policy instance | 7 |
| Insurance contract or identification number | 1004984000 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 $108,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
