THE MATHENY SCHOOL AND HOSPITAL, LNC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN
401k plan membership statisitcs for MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN
Measure | Date | Value |
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2022 : MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2022 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-05-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-05-31 | $200,144 |
Total income from all sources (including contributions) | 2022-05-31 | $5,818,378 |
Total of all expenses incurred | 2022-05-31 | $6,171,939 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-05-31 | $5,920,468 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-05-31 | $5,818,053 |
Value of total assets at end of year | 2022-05-31 | $207,505 |
Value of total assets at beginning of year | 2022-05-31 | $761,210 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-05-31 | $251,471 |
Total interest from all sources | 2022-05-31 | $325 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-05-31 | No |
Was this plan covered by a fidelity bond | 2022-05-31 | Yes |
Value of fidelity bond cover | 2022-05-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2022-05-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2022-05-31 | No |
Contributions received from participants | 2022-05-31 | $1,535,758 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-05-31 | $3,741 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-05-31 | $279,581 |
Administrative expenses (other) incurred | 2022-05-31 | $251,471 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-05-31 | No |
Value of net income/loss | 2022-05-31 | $-353,561 |
Value of net assets at end of year (total assets less liabilities) | 2022-05-31 | $207,505 |
Value of net assets at beginning of year (total assets less liabilities) | 2022-05-31 | $561,066 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-05-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2022-05-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2022-05-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-05-31 | $203,764 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-05-31 | $481,629 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-05-31 | $481,629 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-05-31 | $325 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2022-05-31 | $1,322,038 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-05-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2022-05-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2022-05-31 | No |
Contributions received in cash from employer | 2022-05-31 | $4,282,295 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-05-31 | $4,598,430 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-05-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2022-05-31 | $0 |
Liabilities. Value of benefit claims payable at beginning of year | 2022-05-31 | $200,144 |
Did the plan have assets held for investment | 2022-05-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-05-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-05-31 | No |
Opinion of an independent qualified public accountant for this plan | 2022-05-31 | Unqualified |
Accountancy firm name | 2022-05-31 | BAKER TILLY US, LLP |
Accountancy firm EIN | 2022-05-31 | 390859910 |
2021 : MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2021 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-05-31 | $200,144 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-05-31 | $123,230 |
Total income from all sources (including contributions) | 2021-05-31 | $5,280,706 |
Total of all expenses incurred | 2021-05-31 | $5,120,483 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-05-31 | $4,857,441 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-05-31 | $5,280,543 |
Value of total assets at end of year | 2021-05-31 | $761,210 |
Value of total assets at beginning of year | 2021-05-31 | $524,073 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-05-31 | $263,042 |
Total interest from all sources | 2021-05-31 | $163 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-05-31 | No |
Was this plan covered by a fidelity bond | 2021-05-31 | Yes |
Value of fidelity bond cover | 2021-05-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2021-05-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2021-05-31 | No |
Contributions received from participants | 2021-05-31 | $1,635,493 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-05-31 | $279,581 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-05-31 | $22,645 |
Administrative expenses (other) incurred | 2021-05-31 | $263,042 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-05-31 | No |
Value of net income/loss | 2021-05-31 | $160,223 |
Value of net assets at end of year (total assets less liabilities) | 2021-05-31 | $561,066 |
Value of net assets at beginning of year (total assets less liabilities) | 2021-05-31 | $400,843 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-05-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2021-05-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-05-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-05-31 | $481,629 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-05-31 | $501,428 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-05-31 | $501,428 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-05-31 | $163 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2021-05-31 | $1,214,318 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-05-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2021-05-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2021-05-31 | No |
Contributions received in cash from employer | 2021-05-31 | $3,645,050 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-05-31 | $3,643,123 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-05-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2021-05-31 | $200,144 |
Liabilities. Value of benefit claims payable at beginning of year | 2021-05-31 | $123,230 |
Did the plan have assets held for investment | 2021-05-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-05-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-05-31 | No |
Opinion of an independent qualified public accountant for this plan | 2021-05-31 | Unqualified |
Accountancy firm name | 2021-05-31 | BAKER TILLY US, LLP |
Accountancy firm EIN | 2021-05-31 | 390859910 |
2020 : MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2020 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-05-31 | $123,230 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-05-31 | $116,997 |
Total income from all sources (including contributions) | 2020-05-31 | $5,552,382 |
Total of all expenses incurred | 2020-05-31 | $5,874,412 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-05-31 | $5,585,728 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-05-31 | $5,544,876 |
Value of total assets at end of year | 2020-05-31 | $524,073 |
Value of total assets at beginning of year | 2020-05-31 | $839,870 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-05-31 | $288,684 |
Total interest from all sources | 2020-05-31 | $7,506 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-05-31 | No |
Was this plan covered by a fidelity bond | 2020-05-31 | Yes |
Value of fidelity bond cover | 2020-05-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2020-05-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2020-05-31 | No |
Contributions received from participants | 2020-05-31 | $1,396,933 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-05-31 | $22,645 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-05-31 | $204,792 |
Administrative expenses (other) incurred | 2020-05-31 | $288,684 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-05-31 | No |
Value of net income/loss | 2020-05-31 | $-322,030 |
Value of net assets at end of year (total assets less liabilities) | 2020-05-31 | $400,843 |
Value of net assets at beginning of year (total assets less liabilities) | 2020-05-31 | $722,873 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-05-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-05-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-05-31 | No |
Income. Interest from corporate debt instruments | 2020-05-31 | $7,506 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-05-31 | $501,428 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-05-31 | $235,078 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-05-31 | $235,078 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2020-05-31 | $1,213,154 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-05-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2020-05-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-05-31 | No |
Contributions received in cash from employer | 2020-05-31 | $4,147,943 |
Employer contributions (assets) at end of year | 2020-05-31 | $0 |
Employer contributions (assets) at beginning of year | 2020-05-31 | $400,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-05-31 | $4,372,574 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-05-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2020-05-31 | $123,230 |
Liabilities. Value of benefit claims payable at beginning of year | 2020-05-31 | $116,997 |
Did the plan have assets held for investment | 2020-05-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-05-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-05-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-05-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2020-05-31 | Disclaimer |
Accountancy firm name | 2020-05-31 | BAKER TILLY US, LLP |
Accountancy firm EIN | 2020-05-31 | 390859910 |
2019 : MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2019 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-05-31 | $116,997 |
Total income from all sources (including contributions) | 2019-05-31 | $5,300,011 |
Total of all expenses incurred | 2019-05-31 | $4,577,138 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-05-31 | $4,382,878 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-05-31 | $5,284,550 |
Value of total assets at end of year | 2019-05-31 | $839,870 |
Value of total assets at beginning of year | 2019-05-31 | $0 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-05-31 | $194,260 |
Total interest from all sources | 2019-05-31 | $15,461 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-05-31 | No |
Was this plan covered by a fidelity bond | 2019-05-31 | Yes |
Value of fidelity bond cover | 2019-05-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2019-05-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2019-05-31 | No |
Contributions received from participants | 2019-05-31 | $1,690,180 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-05-31 | $204,792 |
Administrative expenses (other) incurred | 2019-05-31 | $194,260 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-05-31 | No |
Value of net income/loss | 2019-05-31 | $722,873 |
Value of net assets at end of year (total assets less liabilities) | 2019-05-31 | $722,873 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-05-31 | $0 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-05-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-05-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-05-31 | No |
Income. Interest from corporate debt instruments | 2019-05-31 | $15,461 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-05-31 | $235,078 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-05-31 | $0 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-05-31 | $0 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2019-05-31 | $1,045,860 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-05-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2019-05-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-05-31 | No |
Contributions received in cash from employer | 2019-05-31 | $3,594,370 |
Employer contributions (assets) at end of year | 2019-05-31 | $400,000 |
Employer contributions (assets) at beginning of year | 2019-05-31 | $0 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-05-31 | $3,337,018 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-05-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2019-05-31 | $116,997 |
Did the plan have assets held for investment | 2019-05-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-05-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-05-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-05-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2019-05-31 | Disclaimer |
Accountancy firm name | 2019-05-31 | BAKER TILLY VIRCHOW KRAUSE LLP |
Accountancy firm EIN | 2019-05-31 | 390859910 |
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SHD963502 |
Policy instance | 8 |
Insurance contract or identification number | SHD963502 | Number of Individuals Covered | 503 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $15,563 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $189,518 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,646 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 910408 |
Policy instance | 1 |
Insurance contract or identification number | 910408 | Number of Individuals Covered | 192 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $35,923 | Total amount of fees paid to insurance company | USD $3,586 | Welfare Benefit Premiums Paid to Carrier | USD $718,470 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,923 | Amount paid for insurance broker fees | 3586 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX969731 |
Policy instance | 2 |
Insurance contract or identification number | FLX969731 | Number of Individuals Covered | 444 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,992 | Total amount of fees paid to insurance company | USD $2,490 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $49,805 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2490 | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $1,992 |
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DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 ) |
Policy contract number | 07396 |
Policy instance | 3 |
Insurance contract or identification number | 07396 | Number of Individuals Covered | 623 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0752684 |
Policy instance | 4 |
Insurance contract or identification number | 0752684 | Number of Individuals Covered | 441 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,095 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | SL-138069 |
Policy instance | 5 |
Insurance contract or identification number | SL-138069 | Number of Individuals Covered | 295 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $37,179 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | OK 971169 |
Policy instance | 6 |
Insurance contract or identification number | OK 971169 | Number of Individuals Covered | 444 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $226 | Total amount of fees paid to insurance company | USD $282 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $5,645 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 282 | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $226 |
|
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | LK966454 |
Policy instance | 7 |
Insurance contract or identification number | LK966454 | Number of Individuals Covered | 443 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $2,115 | Total amount of fees paid to insurance company | USD $2,644 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $52,877 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2644 | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $2,115 |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | SL-138069 |
Policy instance | 5 |
Insurance contract or identification number | SL-138069 | Number of Individuals Covered | 315 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $38,393 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0752684 |
Policy instance | 4 |
Insurance contract or identification number | 0752684 | Number of Individuals Covered | 247 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $10 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,001 | 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 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 ) |
Policy contract number | 07396 |
Policy instance | 3 |
Insurance contract or identification number | 07396 | Number of Individuals Covered | 646 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 866012G |
Policy instance | 2 |
Insurance contract or identification number | 866012G | Number of Individuals Covered | 531 | 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 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $150,441 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 910408 |
Policy instance | 1 |
Insurance contract or identification number | 910408 | Number of Individuals Covered | 315 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $37,618 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $752,356 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $37,618 | Insurance broker organization code? | 3 |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 910408 |
Policy instance | 1 |
Insurance contract or identification number | 910408 | Number of Individuals Covered | 354 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $70,775 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $736,797 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $49,773 | Insurance broker organization code? | 3 |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 866012G |
Policy instance | 2 |
Insurance contract or identification number | 866012G | Number of Individuals Covered | 531 | Insurance policy start date | 2019-06-01 | 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 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $63,020 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 ) |
Policy contract number | 07396 |
Policy instance | 3 |
Insurance contract or identification number | 07396 | Number of Individuals Covered | 666 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0752684 |
Policy instance | 4 |
Insurance contract or identification number | 0752684 | Number of Individuals Covered | 403 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $3,155 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,464 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,155 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | SL-138069 |
Policy instance | 5 |
Insurance contract or identification number | SL-138069 | Number of Individuals Covered | 350 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $39,342 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | SL-138069 |
Policy instance | 5 |
Insurance contract or identification number | SL-138069 | Number of Individuals Covered | 340 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $33,841 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0752684 |
Policy instance | 4 |
Insurance contract or identification number | 0752684 | Number of Individuals Covered | 207 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $3,012 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,093 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,012 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 ) |
Policy contract number | 07396 |
Policy instance | 3 |
Insurance contract or identification number | 07396 | Number of Individuals Covered | 654 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 866012G |
Policy instance | 2 |
Insurance contract or identification number | 866012G | Number of Individuals Covered | 540 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $247 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $114,097 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 247 | Additional information about fees paid to insurance broker | BONUS PAID | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 910408 |
Policy instance | 1 |
Insurance contract or identification number | 910408 | Number of Individuals Covered | 340 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $31,701 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $628,882 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,561 | Insurance broker organization code? | 3 |
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