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TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 401k Plan overview

Plan NameTERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN
Plan identification number 505

TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

TERESIAN HOUSE NURSING HOME CO., INC has sponsored the creation of one or more 401k plans.

Company Name:TERESIAN HOUSE NURSING HOME CO., INC
Employer identification number (EIN):141539594
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-05-01
5052021-05-01
5052020-05-01
5052019-05-01
5052018-05-01
5052017-05-01MICHAEL DELBROCCO
5052016-05-01MICHAEL DELBROCCO MICHAEL DELBROCCO2017-07-27
5052015-05-01MICHAEL DELBROCCO MICHAEL DELBROCCO2016-08-02
5052014-05-01MICHAEL DELBROCCO MICHAEL DELBROCCO2015-08-28
5052013-05-01MICHAEL DELBROCCO MICHAEL DELBROCCO2014-09-24
5052012-05-01MICHAEL DELBROCCO MICHAEL DELBROCCO2013-08-26
5052011-05-01MICHAEL DELBROCCO
5052010-05-01MICHAEL DELBROCCO
5052009-05-01 MICHAEL DELBROCCO2010-09-29
5052009-05-01MICHAEL DELBROCCO

Plan Statistics for TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN

401k plan membership statisitcs for TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN

Measure Date Value
2022: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01251
Total number of active participants reported on line 7a of the Form 55002022-05-01246
Total of all active and inactive participants2022-05-01246
Total participants2022-05-01246
2021: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01279
Total number of active participants reported on line 7a of the Form 55002021-05-01251
Total of all active and inactive participants2021-05-01251
Total participants2021-05-01251
2020: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01308
Total number of active participants reported on line 7a of the Form 55002020-05-01279
Total of all active and inactive participants2020-05-01279
Total participants2020-05-01279
2019: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01330
Total number of active participants reported on line 7a of the Form 55002019-05-01308
Total of all active and inactive participants2019-05-01308
Total participants2019-05-01308
2018: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01339
Total number of active participants reported on line 7a of the Form 55002018-05-01330
Total of all active and inactive participants2018-05-01330
Total participants2018-05-01330
2017: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01360
Total number of active participants reported on line 7a of the Form 55002017-05-01339
Total of all active and inactive participants2017-05-01339
Total participants2017-05-01339
2016: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01399
Total number of active participants reported on line 7a of the Form 55002016-05-01360
Total of all active and inactive participants2016-05-01360
Total participants2016-05-01360
2015: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01417
Total number of active participants reported on line 7a of the Form 55002015-05-01399
Total of all active and inactive participants2015-05-01399
Total participants2015-05-01399
2014: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-01412
Total number of active participants reported on line 7a of the Form 55002014-05-01416
Number of retired or separated participants receiving benefits2014-05-011
Total of all active and inactive participants2014-05-01417
Total participants2014-05-01417
2013: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01397
Total number of active participants reported on line 7a of the Form 55002013-05-01411
Number of retired or separated participants receiving benefits2013-05-011
Total of all active and inactive participants2013-05-01412
Total participants2013-05-01412
2012: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01204
Total number of active participants reported on line 7a of the Form 55002012-05-01217
Number of retired or separated participants receiving benefits2012-05-011
Total of all active and inactive participants2012-05-01218
Total participants2012-05-01218
2011: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01206
Total number of active participants reported on line 7a of the Form 55002011-05-01203
Number of retired or separated participants receiving benefits2011-05-011
Total of all active and inactive participants2011-05-01204
Total participants2011-05-01204
2010: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-05-01204
Total number of active participants reported on line 7a of the Form 55002010-05-01205
Number of retired or separated participants receiving benefits2010-05-011
Total of all active and inactive participants2010-05-01206
Total participants2010-05-01206
2009: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01211
Total number of active participants reported on line 7a of the Form 55002009-05-01203
Number of retired or separated participants receiving benefits2009-05-011
Total of all active and inactive participants2009-05-01204
Total participants2009-05-01204

Form 5500 Responses for TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN

2022: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2021: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2020: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – General assets of the sponsorYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – General assets of the sponsorYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – General assets of the sponsorYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – General assets of the sponsorYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – General assets of the sponsorYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – General assets of the sponsorYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – General assets of the sponsorYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – General assets of the sponsorYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – General assets of the sponsorYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – General assets of the sponsorYes
2011-05-01Plan benefit arrangement – InsuranceYes
2010: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01Submission has been amendedYes
2010-05-01This submission is the final filingNo
2010-05-01This return/report is a short plan year return/report (less than 12 months)No
2010-05-01Plan is a collectively bargained planNo
2010-05-01Plan funding arrangement – General assets of the sponsorYes
2010-05-01Plan benefit arrangement – InsuranceYes
2009: TERESIAN HOUSE NURSING HOME CAPITAL DISTRICT PHYSICIANS HEALTH PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Submission has been amendedNo
2009-05-01This submission is the final filingNo
2009-05-01This return/report is a short plan year return/report (less than 12 months)No
2009-05-01Plan is a collectively bargained planNo
2009-05-01Plan funding arrangement – General assets of the sponsorYes
2009-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number10008081
Policy instance 1
Insurance contract or identification number10008081
Number of Individuals Covered246
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $76,918
Total amount of fees paid to insurance companyUSD $2,176,719
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number10008081
Policy instance 1
Insurance contract or identification number10008081
Number of Individuals Covered251
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $77,944
Total amount of fees paid to insurance companyUSD $2,217,765
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number10008081
Policy instance 1
Insurance contract or identification number10008081
Number of Individuals Covered279
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $85,512
Total amount of fees paid to insurance companyUSD $2,520,488
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number10008081
Policy instance 1
Insurance contract or identification number10008081
Number of Individuals Covered308
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $86,476
Total amount of fees paid to insurance companyUSD $2,559,031
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number10008081
Policy instance 1
Insurance contract or identification number10008081
Number of Individuals Covered339
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $74,530
Total amount of fees paid to insurance companyUSD $2,484,337
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number10008081
Policy instance 1
Insurance contract or identification number10008081
Number of Individuals Covered399
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $76,454
Total amount of fees paid to insurance companyUSD $2,548,404
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number10008081
Policy instance 1
Insurance contract or identification number10008081
Number of Individuals Covered417
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $73,065
Total amount of fees paid to insurance companyUSD $2,433,929
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number00016
Policy instance 1
Insurance contract or identification number00016
Number of Individuals Covered412
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $67,867
Total amount of fees paid to insurance companyUSD $2,260,543
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number00016
Policy instance 1
Insurance contract or identification number00016
Number of Individuals Covered397
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $62,898
Total amount of fees paid to insurance companyUSD $2,085,303
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number00016
Policy instance 1
Insurance contract or identification number00016
Number of Individuals Covered391
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $59,110
Total amount of fees paid to insurance companyUSD $1,971,483
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number00016
Policy instance 1
Insurance contract or identification number00016
Number of Individuals Covered206
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $55,115
Total amount of fees paid to insurance companyUSD $1,835,156

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