MENTAL HEALTH SERVICES, ERIE COUNTY SOUTH EAST CORP V has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2022: SPECTRUM HUMAN SERVICES 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 228 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 196 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 196 |
| 2021: SPECTRUM HUMAN SERVICES 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 241 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 231 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 231 |
| 2020: SPECTRUM HUMAN SERVICES 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 225 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 237 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 237 |
| 2019: SPECTRUM HUMAN SERVICES 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 210 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 210 |
| 2018: SPECTRUM HUMAN SERVICES 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 161 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 197 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 197 |
| 2017: SPECTRUM HUMAN SERVICES 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 146 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 157 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 157 |
| 2016: SPECTRUM HUMAN SERVICES 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 145 |
| Total of all active and inactive participants | 2016-01-01 | 145 |
| 2015: SPECTRUM HUMAN SERVICES 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 240 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 218 |
| Total of all active and inactive participants | 2015-01-01 | 218 |
| 2014: SPECTRUM HUMAN SERVICES 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 221 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 240 |
| Total of all active and inactive participants | 2014-01-01 | 240 |
| 2013: SPECTRUM HUMAN SERVICES 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 228 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 221 |
| Total of all active and inactive participants | 2013-01-01 | 221 |
| 2012: SPECTRUM HUMAN SERVICES 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 208 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 228 |
| Total of all active and inactive participants | 2012-01-01 | 228 |
| 2011: SPECTRUM HUMAN SERVICES 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 228 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 208 |
| Total of all active and inactive participants | 2011-01-01 | 208 |
| 2010: SPECTRUM HUMAN SERVICES 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 181 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 228 |
| Total of all active and inactive participants | 2010-01-01 | 228 |
| 2009: SPECTRUM HUMAN SERVICES 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 175 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 181 |
| Total of all active and inactive participants | 2009-01-01 | 181 |
| 2008: SPECTRUM HUMAN SERVICES 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-01-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-01-01 | 175 |
| Total of all active and inactive participants | 2008-01-01 | 175 |
| 2007: SPECTRUM HUMAN SERVICES 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-01-01 | 60 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-01-01 | 112 |
| Total of all active and inactive participants | 2007-01-01 | 112 |
| 2022: SPECTRUM HUMAN SERVICES 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: SPECTRUM HUMAN SERVICES 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: SPECTRUM HUMAN SERVICES 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: SPECTRUM HUMAN SERVICES 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: SPECTRUM HUMAN SERVICES 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: SPECTRUM HUMAN SERVICES 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: SPECTRUM HUMAN SERVICES 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: SPECTRUM HUMAN SERVICES 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: SPECTRUM HUMAN SERVICES 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: SPECTRUM HUMAN SERVICES 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: SPECTRUM HUMAN SERVICES 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: SPECTRUM HUMAN SERVICES 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: SPECTRUM HUMAN SERVICES 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: SPECTRUM HUMAN SERVICES 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: SPECTRUM HUMAN SERVICES 2008 form 5500 responses |
|---|
| 2008-01-01 | Type of plan entity | Single employer plan |
| 2008-01-01 | Plan funding arrangement – Insurance | Yes |
| 2008-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2008-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2007: SPECTRUM HUMAN SERVICES 2007 form 5500 responses |
|---|
| 2007-01-01 | Type of plan entity | Single employer plan |
| 2007-01-01 | First time form 5500 has been submitted | Yes |
| 2007-01-01 | Plan funding arrangement – Insurance | Yes |
| 2007-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2007-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 333 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $43,255 | | Total amount of fees paid to insurance company | USD $341,114 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,255 | | Amount paid for insurance broker fees | 341114 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 398 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $57,872 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $57,872 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 389 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $51,320 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $51,320 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 357 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $10,619 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,619 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 332 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $44,867 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,867 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $40,999 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,999 | | Insurance broker organization code? | 3 | | Insurance broker name | NORTHWEST INSURANCE SERVICES |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $38,155 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $38,155 | | Insurance broker name | LAWLEY BENEFITS GRP |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 240 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-01-01 | | Total amount of commissions paid to insurance broker | USD $33,564 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,787 | | Insurance broker name | BROWN & BROWN OF NEW YORK INC |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 221 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $33,609 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $33,609 | | Insurance broker name | BROWN & BROWN OF NEW YORK, INC. |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 228 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $41,859 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $1,195,985 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,859 | | Insurance broker name | BROWN & BROWN OF NEW YORK INC |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 208 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $39,720 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $1,134,865 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,720 | | Insurance broker name | BROWN & BROWN OF NEW YORK, INC. |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 228 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $34,737 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $992,498 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,737 | | Insurance broker name | BROWN & BROWN OF NEW YORK INC. |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 181 | | Insurance policy start date | 2009-01-01 | | Insurance policy end date | 2009-12-31 | | Total amount of commissions paid to insurance broker | USD $24,733 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $706,669 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,733 | | Insurance broker name | BROWN & BROWN OF NEW YORK, INC. |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2008-01-01 | | Insurance policy end date | 2008-12-31 | | Total amount of commissions paid to insurance broker | USD $10,372 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $545,574 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,372 | | Insurance broker name | BROWN & BROWN OF NEW YORK INC. |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310884 |
| Policy instance | 1 |
| Insurance contract or identification number | 00310884 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2007-01-01 | | Insurance policy end date | 2007-12-31 | | 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 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $346,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
