?>
Logo

MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 401k Plan overview

Plan NameMATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN
Plan identification number 501

MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

THE MATHENY SCHOOL AND HOSPITAL, LNC. has sponsored the creation of one or more 401k plans.

Company Name:THE MATHENY SCHOOL AND HOSPITAL, LNC.
Employer identification number (EIN):221482276
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-06-01WILLIAM KENT2023-03-15
5012020-06-01KATHLEEN F. POWERS2022-03-15
5012019-06-01KATHLEEN F. POWERS2021-03-15
5012018-06-01KATHLEEN F. POWERS2020-03-16

Plan Statistics for MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN

401k plan membership statisitcs for MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN

Measure Date Value
2021: MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01505
Total number of active participants reported on line 7a of the Form 55002021-06-01510
Total of all active and inactive participants2021-06-01510
2020: MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01540
Total number of active participants reported on line 7a of the Form 55002020-06-01504
Total of all active and inactive participants2020-06-01504
2019: MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01428
Total number of active participants reported on line 7a of the Form 55002019-06-01450
Number of retired or separated participants receiving benefits2019-06-010
Total of all active and inactive participants2019-06-01450
2018: MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01508
Total number of active participants reported on line 7a of the Form 55002018-06-01427
Number of retired or separated participants receiving benefits2018-06-011
Total of all active and inactive participants2018-06-01428

Financial Data on MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN

Measure Date Value
2022 : MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2022 401k financial data
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 incurred2022-05-31$6,171,939
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-05-31$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 year2022-05-31$207,505
Value of total assets at beginning of year2022-05-31$761,210
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-05-31$251,471
Total interest from all sources2022-05-31$325
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-05-31No
Was this plan covered by a fidelity bond2022-05-31Yes
Value of fidelity bond cover2022-05-31$500,000
If this is an individual account plan, was there a blackout period2022-05-31No
Were there any nonexempt tranactions with any party-in-interest2022-05-31No
Contributions received from participants2022-05-31$1,535,758
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-05-31$3,741
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-05-31$279,581
Administrative expenses (other) incurred2022-05-31$251,471
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Value of net income/loss2022-05-31$-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)2022-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-05-31No
Were any leases to which the plan was party in default or uncollectible2022-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-05-31$203,764
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-05-31$481,629
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-05-31$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 benefits2022-05-31$1,322,038
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-05-31Yes
Was there a failure to transmit to the plan any participant contributions2022-05-31No
Has the plan failed to provide any benefit when due under the plan2022-05-31No
Contributions received in cash from employer2022-05-31$4,282,295
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-05-31$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 2520.101-32022-05-31No
Liabilities. Value of benefit claims payable at end of year2022-05-31$0
Liabilities. Value of benefit claims payable at beginning of year2022-05-31$200,144
Did the plan have assets held for investment2022-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-05-31No
Opinion of an independent qualified public accountant for this plan2022-05-31Unqualified
Accountancy firm name2022-05-31BAKER TILLY US, LLP
Accountancy firm EIN2022-05-31390859910
2021 : MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2021 401k financial data
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 incurred2021-05-31$5,120,483
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-05-31$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 year2021-05-31$761,210
Value of total assets at beginning of year2021-05-31$524,073
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-05-31$263,042
Total interest from all sources2021-05-31$163
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-05-31No
Was this plan covered by a fidelity bond2021-05-31Yes
Value of fidelity bond cover2021-05-31$500,000
If this is an individual account plan, was there a blackout period2021-05-31No
Were there any nonexempt tranactions with any party-in-interest2021-05-31No
Contributions received from participants2021-05-31$1,635,493
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-05-31$279,581
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-05-31$22,645
Administrative expenses (other) incurred2021-05-31$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 appraiser2021-05-31No
Value of net income/loss2021-05-31$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)2021-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-05-31No
Were any leases to which the plan was party in default or uncollectible2021-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-05-31$481,629
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-05-31$501,428
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-05-31$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 benefits2021-05-31$1,214,318
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-05-31Yes
Was there a failure to transmit to the plan any participant contributions2021-05-31No
Has the plan failed to provide any benefit when due under the plan2021-05-31No
Contributions received in cash from employer2021-05-31$3,645,050
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-05-31$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 2520.101-32021-05-31No
Liabilities. Value of benefit claims payable at end of year2021-05-31$200,144
Liabilities. Value of benefit claims payable at beginning of year2021-05-31$123,230
Did the plan have assets held for investment2021-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-05-31No
Opinion of an independent qualified public accountant for this plan2021-05-31Unqualified
Accountancy firm name2021-05-31BAKER TILLY US, LLP
Accountancy firm EIN2021-05-31390859910
2020 : MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2020 401k financial data
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 incurred2020-05-31$5,874,412
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-05-31$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 year2020-05-31$524,073
Value of total assets at beginning of year2020-05-31$839,870
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-05-31$288,684
Total interest from all sources2020-05-31$7,506
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-05-31No
Was this plan covered by a fidelity bond2020-05-31Yes
Value of fidelity bond cover2020-05-31$500,000
If this is an individual account plan, was there a blackout period2020-05-31No
Were there any nonexempt tranactions with any party-in-interest2020-05-31No
Contributions received from participants2020-05-31$1,396,933
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-05-31$22,645
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-05-31$204,792
Administrative expenses (other) incurred2020-05-31$288,684
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Value of net income/loss2020-05-31$-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)2020-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-05-31No
Were any leases to which the plan was party in default or uncollectible2020-05-31No
Income. Interest from corporate debt instruments2020-05-31$7,506
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-05-31$501,428
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-05-31$235,078
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-05-31$235,078
Expenses. Payments to insurance carriers foe the provision of benefits2020-05-31$1,213,154
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-05-31Yes
Was there a failure to transmit to the plan any participant contributions2020-05-31No
Has the plan failed to provide any benefit when due under the plan2020-05-31No
Contributions received in cash from employer2020-05-31$4,147,943
Employer contributions (assets) at end of year2020-05-31$0
Employer contributions (assets) at beginning of year2020-05-31$400,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-05-31$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 2520.101-32020-05-31No
Liabilities. Value of benefit claims payable at end of year2020-05-31$123,230
Liabilities. Value of benefit claims payable at beginning of year2020-05-31$116,997
Did the plan have assets held for investment2020-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-05-31Yes
Opinion of an independent qualified public accountant for this plan2020-05-31Disclaimer
Accountancy firm name2020-05-31BAKER TILLY US, LLP
Accountancy firm EIN2020-05-31390859910
2019 : MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2019 401k financial data
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 incurred2019-05-31$4,577,138
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-05-31$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 year2019-05-31$839,870
Value of total assets at beginning of year2019-05-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-05-31$194,260
Total interest from all sources2019-05-31$15,461
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-05-31No
Was this plan covered by a fidelity bond2019-05-31Yes
Value of fidelity bond cover2019-05-31$500,000
If this is an individual account plan, was there a blackout period2019-05-31No
Were there any nonexempt tranactions with any party-in-interest2019-05-31No
Contributions received from participants2019-05-31$1,690,180
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-05-31$204,792
Administrative expenses (other) incurred2019-05-31$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 appraiser2019-05-31No
Value of net income/loss2019-05-31$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)2019-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-05-31No
Were any leases to which the plan was party in default or uncollectible2019-05-31No
Income. Interest from corporate debt instruments2019-05-31$15,461
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-05-31$235,078
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-05-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-05-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-05-31$1,045,860
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-05-31Yes
Was there a failure to transmit to the plan any participant contributions2019-05-31No
Has the plan failed to provide any benefit when due under the plan2019-05-31No
Contributions received in cash from employer2019-05-31$3,594,370
Employer contributions (assets) at end of year2019-05-31$400,000
Employer contributions (assets) at beginning of year2019-05-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-05-31$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 2520.101-32019-05-31No
Liabilities. Value of benefit claims payable at end of year2019-05-31$116,997
Did the plan have assets held for investment2019-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-05-31Yes
Opinion of an independent qualified public accountant for this plan2019-05-31Disclaimer
Accountancy firm name2019-05-31BAKER TILLY VIRCHOW KRAUSE LLP
Accountancy firm EIN2019-05-31390859910

Form 5500 Responses for MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN

2021: MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan funding arrangement – TrustYes
2021-06-01Plan funding arrangement – General assets of the sponsorYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-06-01Plan benefit arrangement - TrustYes
2021-06-01Plan benefit arrangement – General assets of the sponsorYes
2020: MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan funding arrangement – TrustYes
2020-06-01Plan funding arrangement – General assets of the sponsorYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-06-01Plan benefit arrangement - TrustYes
2020-06-01Plan benefit arrangement – General assets of the sponsorYes
2019: MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan funding arrangement – TrustYes
2019-06-01Plan funding arrangement – General assets of the sponsorYes
2019-06-01Plan benefit arrangement – InsuranceYes
2019-06-01Plan benefit arrangement - TrustYes
2019-06-01Plan benefit arrangement – General assets of the sponsorYes
2018: MATHENY SCHOOL AND HOSPITAL, INC. HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01First time form 5500 has been submittedYes
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan funding arrangement – TrustYes
2018-06-01Plan funding arrangement – General assets of the sponsorYes
2018-06-01Plan benefit arrangement – InsuranceYes
2018-06-01Plan benefit arrangement - TrustYes
2018-06-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSHD963502
Policy instance 8
Insurance contract or identification numberSHD963502
Number of Individuals Covered503
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $15,563
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $189,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,646
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number910408
Policy instance 1
Insurance contract or identification number910408
Number of Individuals Covered192
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $35,923
Total amount of fees paid to insurance companyUSD $3,586
Welfare Benefit Premiums Paid to CarrierUSD $718,470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,923
Amount paid for insurance broker fees3586
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX969731
Policy instance 2
Insurance contract or identification numberFLX969731
Number of Individuals Covered444
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,992
Total amount of fees paid to insurance companyUSD $2,490
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 fees2490
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,992
DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 )
Policy contract number07396
Policy instance 3
Insurance contract or identification number07396
Number of Individuals Covered623
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
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 number0752684
Policy instance 4
Insurance contract or identification number0752684
Number of Individuals Covered441
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberSL-138069
Policy instance 5
Insurance contract or identification numberSL-138069
Number of Individuals Covered295
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $37,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 971169
Policy instance 6
Insurance contract or identification numberOK 971169
Number of Individuals Covered444
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $226
Total amount of fees paid to insurance companyUSD $282
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $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 fees282
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $226
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK966454
Policy instance 7
Insurance contract or identification numberLK966454
Number of Individuals Covered443
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,115
Total amount of fees paid to insurance companyUSD $2,644
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 fees2644
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $2,115
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberSL-138069
Policy instance 5
Insurance contract or identification numberSL-138069
Number of Individuals Covered315
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $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 number0752684
Policy instance 4
Insurance contract or identification number0752684
Number of Individuals Covered247
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $10
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10
Insurance broker organization code?3
DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 )
Policy contract number07396
Policy instance 3
Insurance contract or identification number07396
Number of Individuals Covered646
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number866012G
Policy instance 2
Insurance contract or identification number866012G
Number of Individuals Covered531
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $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 number910408
Policy instance 1
Insurance contract or identification number910408
Number of Individuals Covered315
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $37,618
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $752,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,618
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number910408
Policy instance 1
Insurance contract or identification number910408
Number of Individuals Covered354
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $70,775
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $736,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,773
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number866012G
Policy instance 2
Insurance contract or identification number866012G
Number of Individuals Covered531
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $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 number07396
Policy instance 3
Insurance contract or identification number07396
Number of Individuals Covered666
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
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 number0752684
Policy instance 4
Insurance contract or identification number0752684
Number of Individuals Covered403
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $3,155
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,155
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberSL-138069
Policy instance 5
Insurance contract or identification numberSL-138069
Number of Individuals Covered350
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $39,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberSL-138069
Policy instance 5
Insurance contract or identification numberSL-138069
Number of Individuals Covered340
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $33,841
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 number0752684
Policy instance 4
Insurance contract or identification number0752684
Number of Individuals Covered207
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $3,012
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,012
Insurance broker organization code?3
DELTA DENTAL OF NJ INC (National Association of Insurance Commissioners NAIC id number: 55085 )
Policy contract number07396
Policy instance 3
Insurance contract or identification number07396
Number of Individuals Covered654
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number866012G
Policy instance 2
Insurance contract or identification number866012G
Number of Individuals Covered540
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $247
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $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 fees247
Additional information about fees paid to insurance brokerBONUS PAID
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number910408
Policy instance 1
Insurance contract or identification number910408
Number of Individuals Covered340
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $31,701
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $628,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,561
Insurance broker organization code?3

Was this data useful?
If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us.

Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer
The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Copyright © Market Footprint Ltd
Contact us   Datalog Company Directory
401k Lookup     VAT Lookup S3