401k Plan data: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN plan

LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 401k Plan overview

Plan Name	LUZERNE COUNTY HEAD START GROUP HEALTH PLAN
Plan identification number	501

LUZERNE COUNTY HEAD START GROUP HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

LUZERNE COUNTY HEAD START, INC. has sponsored the creation of one or more 401k plans.

Company Name: LUZERNE COUNTY HEAD START, INC.

Employer identification number (EIN): 232083753

NAIC Classification: 624410
NAIC Description: Child Day Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LUZERNE COUNTY HEAD START GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-07-01
501 2018-07-01
501 2017-07-01 JAMES MCANDREW
501 2016-07-01 JAMES MCANDREW
501 2015-07-01 JAMES MCANDREW
501 2014-07-01 JAMES MCANDREW
501 2013-07-01 JAMES MCANDREW
501 2012-07-01 JAMES MCANDREW
501 2011-07-01 JAMES MCANDREW
501 2010-01-01 JAMES MCANDREW
501 2009-01-01 JAMES MCANDREW
501 2009-01-01 JAMES MCANDREW

Plan Statistics for LUZERNE COUNTY HEAD START GROUP HEALTH PLAN

401k plan membership statisitcs for LUZERNE COUNTY HEAD START GROUP HEALTH PLAN

Measure Date Value
2019: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 325
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 319
Number of retired or separated participants receiving benefits 2019-07-01 6
Number of other retired or separated participants entitled to future benefits 2019-07-01 0
Total of all active and inactive participants 2019-07-01 325
Total participants 2019-07-01 325
2018: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 324
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 321
Number of retired or separated participants receiving benefits 2018-07-01 3
Number of other retired or separated participants entitled to future benefits 2018-07-01 0
Total of all active and inactive participants 2018-07-01 324
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 324
Number of participants with account balances 2018-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 0
2017: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 312
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 307
Number of retired or separated participants receiving benefits 2017-07-01 5
Number of other retired or separated participants entitled to future benefits 2017-07-01 0
Total of all active and inactive participants 2017-07-01 312
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 312
Number of participants with account balances 2017-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 0
2016: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 314
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 301
Number of retired or separated participants receiving benefits 2016-07-01 13
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 314
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 314
Number of participants with account balances 2016-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 140
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 134
Number of retired or separated participants receiving benefits 2015-07-01 6
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 140
Number of participants with account balances 2015-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 416
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 407
Number of retired or separated participants receiving benefits 2014-07-01 9
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 416
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 416
Number of participants with account balances 2014-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 132
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 130
Number of retired or separated participants receiving benefits 2013-07-01 2
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 132
Number of participants with account balances 2013-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
Number of employers contributing to the scheme 2013-07-01 0
2012: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 437
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 428
Number of retired or separated participants receiving benefits 2012-07-01 9
Number of other retired or separated participants entitled to future benefits 2012-07-01 0
Total of all active and inactive participants 2012-07-01 437
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 437
Number of participants with account balances 2012-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
Number of employers contributing to the scheme 2012-07-01 0
2011: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 190
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 183
Number of retired or separated participants receiving benefits 2011-07-01 7
Number of other retired or separated participants entitled to future benefits 2011-07-01 0
Total of all active and inactive participants 2011-07-01 190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 190
Number of participants with account balances 2011-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2010: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 152
Number of retired or separated participants receiving benefits 2010-01-01 8
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 160
Total participants 2010-01-01 160
2009: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 245
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 245
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 245

Measure	Date	Value
2019: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	325
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	319
Number of retired or separated participants receiving benefits	2019-07-01	6
Number of other retired or separated participants entitled to future benefits	2019-07-01	0
Total of all active and inactive participants	2019-07-01	325
Total participants	2019-07-01	325
2018: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	324
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	321
Number of retired or separated participants receiving benefits	2018-07-01	3
Number of other retired or separated participants entitled to future benefits	2018-07-01	0
Total of all active and inactive participants	2018-07-01	324
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	324
Number of participants with account balances	2018-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	0
2017: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	312
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	307
Number of retired or separated participants receiving benefits	2017-07-01	5
Number of other retired or separated participants entitled to future benefits	2017-07-01	0
Total of all active and inactive participants	2017-07-01	312
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	312
Number of participants with account balances	2017-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	0
2016: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	314
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	301
Number of retired or separated participants receiving benefits	2016-07-01	13
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	314
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	314
Number of participants with account balances	2016-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	140
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	134
Number of retired or separated participants receiving benefits	2015-07-01	6
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	140
Number of participants with account balances	2015-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	416
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	407
Number of retired or separated participants receiving benefits	2014-07-01	9
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	416
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	416
Number of participants with account balances	2014-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	132
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	130
Number of retired or separated participants receiving benefits	2013-07-01	2
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	132
Number of participants with account balances	2013-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
Number of employers contributing to the scheme	2013-07-01	0
2012: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	437
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	428
Number of retired or separated participants receiving benefits	2012-07-01	9
Number of other retired or separated participants entitled to future benefits	2012-07-01	0
Total of all active and inactive participants	2012-07-01	437
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	437
Number of participants with account balances	2012-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
Number of employers contributing to the scheme	2012-07-01	0
2011: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	190
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	183
Number of retired or separated participants receiving benefits	2011-07-01	7
Number of other retired or separated participants entitled to future benefits	2011-07-01	0
Total of all active and inactive participants	2011-07-01	190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	190
Number of participants with account balances	2011-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2010: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	152
Number of retired or separated participants receiving benefits	2010-01-01	8
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	160
Total participants	2010-01-01	160
2009: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	245
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	245
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	245

Financial Data on LUZERNE COUNTY HEAD START GROUP HEALTH PLAN

Measure	Date	Value
2020 : LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets	2020-06-30	$0
Unrealized appreciation/depreciation of real estate assets	2020-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-06-30	$0
Total unrealized appreciation/depreciation of assets	2020-06-30	$0
Total unrealized appreciation/depreciation of assets	2020-06-30	$0
Total transfer of assets to this plan	2020-06-30	$0
Total transfer of assets to this plan	2020-06-30	$0
Total transfer of assets from this plan	2020-06-30	$0
Total transfer of assets from this plan	2020-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$1,871,377
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$1,871,377
Expenses. Interest paid	2020-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2020-06-30	$0
Expenses. Interest paid	2020-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2020-06-30	$0
Total income from all sources (including contributions)	2020-06-30	$1,871,377
Total income from all sources (including contributions)	2020-06-30	$1,871,377
Total loss/gain on sale of assets	2020-06-30	$0
Total loss/gain on sale of assets	2020-06-30	$0
Total of all expenses incurred	2020-06-30	$1,871,377
Total of all expenses incurred	2020-06-30	$1,871,377
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$1,871,377
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$1,871,377
Expenses. Certain deemed distributions of participant loans	2020-06-30	$0
Expenses. Certain deemed distributions of participant loans	2020-06-30	$0
Value of total corrective distributions	2020-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$1,871,377
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$1,871,377
Value of total assets at end of year	2020-06-30	$0
Value of total assets at end of year	2020-06-30	$0
Value of total assets at beginning of year	2020-06-30	$1,871,377
Value of total assets at beginning of year	2020-06-30	$1,871,377
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$0
Total income from rents	2020-06-30	$0
Total income from rents	2020-06-30	$0
Total interest from all sources	2020-06-30	$0
Total interest from all sources	2020-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-06-30	$0
Total dividends received from registered investment company shares (eg mutual funds)	2020-06-30	$0
Assets. Real estate other than employer real property at end of year	2020-06-30	$0
Assets. Real estate other than employer real property at end of year	2020-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2020-06-30	$0
Administrative expenses professional fees incurred	2020-06-30	$0
Administrative expenses professional fees incurred	2020-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2020-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2020-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2020-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2020-06-30	$0
Was this plan covered by a fidelity bond	2020-06-30	No
Was this plan covered by a fidelity bond	2020-06-30	No
If this is an individual account plan, was there a blackout period	2020-06-30	No
If this is an individual account plan, was there a blackout period	2020-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$580,146
Contributions received from participants	2020-06-30	$580,146
Participant contributions at end of year	2020-06-30	$0
Participant contributions at end of year	2020-06-30	$0
Participant contributions at beginning of year	2020-06-30	$0
Participant contributions at beginning of year	2020-06-30	$0
Participant contributions at end of year	2020-06-30	$0
Participant contributions at end of year	2020-06-30	$0
Participant contributions at beginning of year	2020-06-30	$580,146
Participant contributions at beginning of year	2020-06-30	$580,146
Assets. Other investments not covered elsewhere at end of year	2020-06-30	$0
Assets. Other investments not covered elsewhere at end of year	2020-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-06-30	$0
Assets. Loans (other than to participants) at end of year	2020-06-30	$0
Assets. Loans (other than to participants) at end of year	2020-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2020-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2020-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-06-30	$0
Other income not declared elsewhere	2020-06-30	$0
Other income not declared elsewhere	2020-06-30	$0
Administrative expenses (other) incurred	2020-06-30	$0
Administrative expenses (other) incurred	2020-06-30	$0
Liabilities. Value of operating payables at end of year	2020-06-30	$0
Liabilities. Value of operating payables at end of year	2020-06-30	$0
Liabilities. Value of operating payables at beginning of year	2020-06-30	$0
Liabilities. Value of operating payables at beginning of year	2020-06-30	$0
Total non interest bearing cash at end of year	2020-06-30	$0
Total non interest bearing cash at end of year	2020-06-30	$0
Total non interest bearing cash at beginning of year	2020-06-30	$0
Total non interest bearing cash at beginning of year	2020-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Income. Non cash contributions	2020-06-30	$0
Income. Non cash contributions	2020-06-30	$0
Value of net income/loss	2020-06-30	$0
Value of net income/loss	2020-06-30	$0
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$0
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Assets. partnership/joint venture interests at end of year	2020-06-30	$0
Assets. partnership/joint venture interests at end of year	2020-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2020-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2020-06-30	$0
Investment advisory and management fees	2020-06-30	$0
Investment advisory and management fees	2020-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-06-30	$0
Value of interest in pooled separate accounts at end of year	2020-06-30	$0
Value of interest in pooled separate accounts at end of year	2020-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2020-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2020-06-30	$0
Interest on participant loans	2020-06-30	$0
Interest on participant loans	2020-06-30	$0
Income. Interest from loans (other than to participants)	2020-06-30	$0
Income. Interest from loans (other than to participants)	2020-06-30	$0
Interest earned on other investments	2020-06-30	$0
Interest earned on other investments	2020-06-30	$0
Income. Interest from US Government securities	2020-06-30	$0
Income. Interest from US Government securities	2020-06-30	$0
Income. Interest from corporate debt instruments	2020-06-30	$0
Income. Interest from corporate debt instruments	2020-06-30	$0
Value of interest in master investment trust accounts at end of year	2020-06-30	$0
Value of interest in master investment trust accounts at end of year	2020-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2020-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2020-06-30	$0
Value of interest in common/collective trusts at end of year	2020-06-30	$0
Value of interest in common/collective trusts at end of year	2020-06-30	$0
Value of interest in common/collective trusts at beginning of year	2020-06-30	$0
Value of interest in common/collective trusts at beginning of year	2020-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2020-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2020-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2020-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2020-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-06-30	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2020-06-30	$1,871,377
Expenses. Payments to insurance carriers foe the provision of benefits	2020-06-30	$1,871,377
Asset value of US Government securities at end of year	2020-06-30	$0
Asset value of US Government securities at end of year	2020-06-30	$0
Asset value of US Government securities at beginning of year	2020-06-30	$0
Asset value of US Government securities at beginning of year	2020-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-06-30	$0
Net investment gain/loss from pooled separate accounts	2020-06-30	$0
Net investment gain/loss from pooled separate accounts	2020-06-30	$0
Net investment gain or loss from common/collective trusts	2020-06-30	$0
Net investment gain or loss from common/collective trusts	2020-06-30	$0
Net gain/loss from 103.12 investment entities	2020-06-30	$0
Net gain/loss from 103.12 investment entities	2020-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Assets. Invements in employer securities at end of year	2020-06-30	$0
Assets. Invements in employer securities at end of year	2020-06-30	$0
Assets. Invements in employer securities at beginning of year	2020-06-30	$0
Assets. Invements in employer securities at beginning of year	2020-06-30	$0
Assets. Value of employer real property at end of year	2020-06-30	$0
Assets. Value of employer real property at end of year	2020-06-30	$0
Assets. Value of employer real property at beginning of year	2020-06-30	$0
Assets. Value of employer real property at beginning of year	2020-06-30	$0
Contributions received in cash from employer	2020-06-30	$1,291,231
Contributions received in cash from employer	2020-06-30	$1,291,231
Employer contributions (assets) at end of year	2020-06-30	$0
Employer contributions (assets) at end of year	2020-06-30	$0
Employer contributions (assets) at beginning of year	2020-06-30	$1,291,231
Employer contributions (assets) at beginning of year	2020-06-30	$1,291,231
Income. Dividends from preferred stock	2020-06-30	$0
Income. Dividends from preferred stock	2020-06-30	$0
Income. Dividends from common stock	2020-06-30	$0
Income. Dividends from common stock	2020-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$0
Asset. Corporate debt instrument preferred debt at end of year	2020-06-30	$0
Asset. Corporate debt instrument preferred debt at end of year	2020-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2020-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2020-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2020-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2020-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2020-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2020-06-30	$0
Contract administrator fees	2020-06-30	$0
Contract administrator fees	2020-06-30	$0
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	2020-06-30	No
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	2020-06-30	No
Assets. Corporate common stocks other than exployer securities at end of year	2020-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2020-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2020-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2020-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2020-06-30	$1,871,377
Liabilities. Value of benefit claims payable at beginning of year	2020-06-30	$1,871,377
Assets. Value of buildings and other operty used in plan operation at end of year	2020-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2020-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-06-30	$0
Did the plan have assets held for investment	2020-06-30	No
Did the plan have assets held for investment	2020-06-30	No
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	2020-06-30	No
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	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Aggregate proceeds on sale of assets	2020-06-30	$0
Aggregate proceeds on sale of assets	2020-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2020-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2020-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2020-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2020-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	No
Opinion of an independent qualified public accountant for this plan	2020-06-30	Unqualified
Opinion of an independent qualified public accountant for this plan	2020-06-30	Unqualified
2018 : LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-06-30	$0
Total unrealized appreciation/depreciation of assets	2018-06-30	$0
Total transfer of assets to this plan	2018-06-30	$0
Total transfer of assets from this plan	2018-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$1,775,674
Total income from all sources (including contributions)	2018-06-30	$1,775,674
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$1,775,674
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$1,775,674
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$1,775,674
Value of total assets at end of year	2018-06-30	$0
Value of total assets at beginning of year	2018-06-30	$1,775,674
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$0
Total interest from all sources	2018-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-06-30	$0
Assets. Real estate other than employer real property at end of year	2018-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2018-06-30	$0
Administrative expenses professional fees incurred	2018-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2018-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2018-06-30	$0
Was this plan covered by a fidelity bond	2018-06-30	No
If this is an individual account plan, was there a blackout period	2018-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$550,459
Participant contributions at end of year	2018-06-30	$0
Participant contributions at beginning of year	2018-06-30	$0
Participant contributions at end of year	2018-06-30	$0
Participant contributions at beginning of year	2018-06-30	$550,459
Assets. Other investments not covered elsewhere at end of year	2018-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2018-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-06-30	$0
Assets. Loans (other than to participants) at end of year	2018-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2018-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-06-30	$0
Other income not declared elsewhere	2018-06-30	$0
Administrative expenses (other) incurred	2018-06-30	$0
Liabilities. Value of operating payables at end of year	2018-06-30	$0
Liabilities. Value of operating payables at beginning of year	2018-06-30	$0
Total non interest bearing cash at end of year	2018-06-30	$0
Total non interest bearing cash at beginning of year	2018-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Income. Non cash contributions	2018-06-30	$0
Value of net income/loss	2018-06-30	$0
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Assets. partnership/joint venture interests at end of year	2018-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2018-06-30	$0
Investment advisory and management fees	2018-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-06-30	$0
Value of interest in pooled separate accounts at end of year	2018-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2018-06-30	$0
Interest on participant loans	2018-06-30	$0
Income. Interest from loans (other than to participants)	2018-06-30	$0
Interest earned on other investments	2018-06-30	$0
Income. Interest from US Government securities	2018-06-30	$0
Income. Interest from corporate debt instruments	2018-06-30	$0
Value of interest in master investment trust accounts at end of year	2018-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2018-06-30	$0
Value of interest in common/collective trusts at end of year	2018-06-30	$0
Value of interest in common/collective trusts at beginning of year	2018-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2018-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2018-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-06-30	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2018-06-30	$1,775,674
Asset value of US Government securities at end of year	2018-06-30	$0
Asset value of US Government securities at beginning of year	2018-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-06-30	$0
Net investment gain/loss from pooled separate accounts	2018-06-30	$0
Net investment gain or loss from common/collective trusts	2018-06-30	$0
Net gain/loss from 103.12 investment entities	2018-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	No
Was there a failure to transmit to the plan any participant contributions	2018-06-30	No
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Assets. Invements in employer securities at end of year	2018-06-30	$0
Assets. Invements in employer securities at beginning of year	2018-06-30	$0
Assets. Value of employer real property at end of year	2018-06-30	$0
Assets. Value of employer real property at beginning of year	2018-06-30	$0
Contributions received in cash from employer	2018-06-30	$1,225,215
Employer contributions (assets) at end of year	2018-06-30	$0
Employer contributions (assets) at beginning of year	2018-06-30	$1,225,215
Income. Dividends from preferred stock	2018-06-30	$0
Income. Dividends from common stock	2018-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$0
Asset. Corporate debt instrument preferred debt at end of year	2018-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2018-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2018-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2018-06-30	$0
Contract administrator fees	2018-06-30	$0
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	2018-06-30	No
Assets. Corporate common stocks other than exployer securities at end of year	2018-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2018-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-06-30	$1,775,674
Assets. Value of buildings and other operty used in plan operation at end of year	2018-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-06-30	$0
Did the plan have assets held for investment	2018-06-30	No
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	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Aggregate proceeds on sale of assets	2018-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2018-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2018-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	No
Opinion of an independent qualified public accountant for this plan	2018-06-30	Unqualified
2017 : LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-06-30	$0
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total transfer of assets to this plan	2017-06-30	$0
Total transfer of assets from this plan	2017-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$1,528,984
Expenses. Interest paid	2017-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$1,528,984
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$1,528,984
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$1,528,984
Expenses. Certain deemed distributions of participant loans	2017-06-30	$0
Value of total corrective distributions	2017-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$1,528,984
Value of total assets at end of year	2017-06-30	$0
Value of total assets at beginning of year	2017-06-30	$1,528,984
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$0
Total income from rents	2017-06-30	$0
Total interest from all sources	2017-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-06-30	$0
Assets. Real estate other than employer real property at end of year	2017-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2017-06-30	$0
Administrative expenses professional fees incurred	2017-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2017-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2017-06-30	$0
Was this plan covered by a fidelity bond	2017-06-30	No
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$473,985
Participant contributions at end of year	2017-06-30	$0
Participant contributions at beginning of year	2017-06-30	$0
Participant contributions at end of year	2017-06-30	$0
Participant contributions at beginning of year	2017-06-30	$473,985
Assets. Other investments not covered elsewhere at end of year	2017-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2017-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-06-30	$0
Assets. Loans (other than to participants) at end of year	2017-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2017-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-06-30	$0
Other income not declared elsewhere	2017-06-30	$0
Administrative expenses (other) incurred	2017-06-30	$0
Liabilities. Value of operating payables at end of year	2017-06-30	$0
Liabilities. Value of operating payables at beginning of year	2017-06-30	$0
Total non interest bearing cash at end of year	2017-06-30	$0
Total non interest bearing cash at beginning of year	2017-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Income. Non cash contributions	2017-06-30	$0
Value of net income/loss	2017-06-30	$0
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Assets. partnership/joint venture interests at end of year	2017-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2017-06-30	$0
Investment advisory and management fees	2017-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$0
Value of interest in pooled separate accounts at end of year	2017-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2017-06-30	$0
Interest on participant loans	2017-06-30	$0
Income. Interest from loans (other than to participants)	2017-06-30	$0
Interest earned on other investments	2017-06-30	$0
Income. Interest from US Government securities	2017-06-30	$0
Income. Interest from corporate debt instruments	2017-06-30	$0
Value of interest in master investment trust accounts at end of year	2017-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2017-06-30	$0
Value of interest in common/collective trusts at end of year	2017-06-30	$0
Value of interest in common/collective trusts at beginning of year	2017-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2017-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2017-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2017-06-30	$1,528,984
Asset value of US Government securities at end of year	2017-06-30	$0
Asset value of US Government securities at beginning of year	2017-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-06-30	$0
Net investment gain/loss from pooled separate accounts	2017-06-30	$0
Net investment gain or loss from common/collective trusts	2017-06-30	$0
Net gain/loss from 103.12 investment entities	2017-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Assets. Invements in employer securities at end of year	2017-06-30	$0
Assets. Invements in employer securities at beginning of year	2017-06-30	$0
Assets. Value of employer real property at end of year	2017-06-30	$0
Assets. Value of employer real property at beginning of year	2017-06-30	$0
Contributions received in cash from employer	2017-06-30	$1,054,999
Employer contributions (assets) at end of year	2017-06-30	$0
Employer contributions (assets) at beginning of year	2017-06-30	$1,054,999
Income. Dividends from preferred stock	2017-06-30	$0
Income. Dividends from common stock	2017-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$0
Asset. Corporate debt instrument preferred debt at end of year	2017-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2017-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2017-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2017-06-30	$0
Contract administrator fees	2017-06-30	$0
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	2017-06-30	No
Assets. Corporate common stocks other than exployer securities at end of year	2017-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2017-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2017-06-30	$1,528,984
Assets. Value of buildings and other operty used in plan operation at end of year	2017-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2017-06-30	$0
Did the plan have assets held for investment	2017-06-30	No
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	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Aggregate proceeds on sale of assets	2017-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2017-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2017-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	No
Opinion of an independent qualified public accountant for this plan	2017-06-30	Unqualified
2016 : LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets	2016-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2016-06-30	$0
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total transfer of assets to this plan	2016-06-30	$0
Total transfer of assets from this plan	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$1,383,758
Expenses. Interest paid	2016-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$1,383,758
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$1,383,758
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$1,383,758
Expenses. Certain deemed distributions of participant loans	2016-06-30	$0
Value of total corrective distributions	2016-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$1,383,758
Value of total assets at end of year	2016-06-30	$0
Value of total assets at beginning of year	2016-06-30	$1,383,758
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$0
Total income from rents	2016-06-30	$0
Total interest from all sources	2016-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-06-30	$0
Assets. Real estate other than employer real property at end of year	2016-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2016-06-30	$0
Administrative expenses professional fees incurred	2016-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2016-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-06-30	$0
Was this plan covered by a fidelity bond	2016-06-30	No
If this is an individual account plan, was there a blackout period	2016-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$428,965
Participant contributions at end of year	2016-06-30	$0
Participant contributions at beginning of year	2016-06-30	$0
Participant contributions at end of year	2016-06-30	$0
Participant contributions at beginning of year	2016-06-30	$428,965
Assets. Other investments not covered elsewhere at end of year	2016-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-06-30	$0
Assets. Loans (other than to participants) at end of year	2016-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2016-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-06-30	$0
Other income not declared elsewhere	2016-06-30	$0
Administrative expenses (other) incurred	2016-06-30	$0
Liabilities. Value of operating payables at end of year	2016-06-30	$0
Liabilities. Value of operating payables at beginning of year	2016-06-30	$0
Total non interest bearing cash at end of year	2016-06-30	$0
Total non interest bearing cash at beginning of year	2016-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Income. Non cash contributions	2016-06-30	$0
Value of net income/loss	2016-06-30	$0
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Assets. partnership/joint venture interests at end of year	2016-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2016-06-30	$0
Investment advisory and management fees	2016-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$0
Value of interest in pooled separate accounts at end of year	2016-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2016-06-30	$0
Interest on participant loans	2016-06-30	$0
Income. Interest from loans (other than to participants)	2016-06-30	$0
Interest earned on other investments	2016-06-30	$0
Income. Interest from US Government securities	2016-06-30	$0
Income. Interest from corporate debt instruments	2016-06-30	$0
Value of interest in master investment trust accounts at end of year	2016-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2016-06-30	$0
Value of interest in common/collective trusts at end of year	2016-06-30	$0
Value of interest in common/collective trusts at beginning of year	2016-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2016-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2016-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2016-06-30	$1,383,758
Asset value of US Government securities at end of year	2016-06-30	$0
Asset value of US Government securities at beginning of year	2016-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-06-30	$0
Net investment gain/loss from pooled separate accounts	2016-06-30	$0
Net investment gain or loss from common/collective trusts	2016-06-30	$0
Net gain/loss from 103.12 investment entities	2016-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Assets. Invements in employer securities at end of year	2016-06-30	$0
Assets. Invements in employer securities at beginning of year	2016-06-30	$0
Assets. Value of employer real property at end of year	2016-06-30	$0
Assets. Value of employer real property at beginning of year	2016-06-30	$0
Contributions received in cash from employer	2016-06-30	$954,793
Employer contributions (assets) at end of year	2016-06-30	$0
Employer contributions (assets) at beginning of year	2016-06-30	$954,793
Income. Dividends from preferred stock	2016-06-30	$0
Income. Dividends from common stock	2016-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$0
Asset. Corporate debt instrument preferred debt at end of year	2016-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2016-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2016-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-06-30	$0
Contract administrator fees	2016-06-30	$0
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	2016-06-30	No
Assets. Corporate common stocks other than exployer securities at end of year	2016-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2016-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-06-30	$1,383,758
Assets. Value of buildings and other operty used in plan operation at end of year	2016-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-06-30	$0
Did the plan have assets held for investment	2016-06-30	No
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	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Aggregate proceeds on sale of assets	2016-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2016-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2016-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2016-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	No
Opinion of an independent qualified public accountant for this plan	2016-06-30	Unqualified

Form 5500 Responses for LUZERNE COUNTY HEAD START GROUP HEALTH PLAN

2019: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2018: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	First time form 5500 has been submitted	Yes
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2017: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	First time form 5500 has been submitted	Yes
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2016: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	First time form 5500 has been submitted	Yes
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	First time form 5500 has been submitted	Yes
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	First time form 5500 has been submitted	Yes
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	First time form 5500 has been submitted	Yes
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	First time form 5500 has been submitted	Yes
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2011: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	First time form 5500 has been submitted	Yes
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2010: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: LUZERNE COUNTY HEAD START GROUP HEALTH PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	Yes
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )

Policy contract number

117994

Policy instance

Insurance contract or identification number	117994
Number of Individuals Covered	325
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $46,784
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $46,784
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )

Policy contract number

117994

Policy instance

Insurance contract or identification number	117994
Number of Individuals Covered	324
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $54,788
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $54,788
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )

Policy contract number

117994

Policy instance

Insurance contract or identification number	117994
Number of Individuals Covered	312
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $44,392
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $44,392
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	CREATIVE BENEFITS, INC.

GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )

Policy contract number

20150630

Policy instance

Insurance contract or identification number	20150630
Number of Individuals Covered	140
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $34,594
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $34,594
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	CREATIVE BENEFITS, INC.

GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )

Policy contract number

20150630

Policy instance

Insurance contract or identification number	20150630
Number of Individuals Covered	416
Insurance policy start date	2015-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $38,820
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $38,820
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	CREATIVE BENEFITS INC.

GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )

Policy contract number

116676

Policy instance

Insurance contract or identification number	116676
Number of Individuals Covered	132
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $31,622
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,622
Insurance broker organization code?	3
Insurance broker name	HOWELL BENEFIT SERVICES

GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )

Policy contract number

10743

Policy instance

Insurance contract or identification number	10743
Number of Individuals Covered	437
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $36,313
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,313
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SALES COMMISSION
Insurance broker organization code?	3
Insurance broker name	HOWELL BENEFIT SERVICES

GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )

Policy contract number

10743

Policy instance

Insurance contract or identification number	10743
Number of Individuals Covered	190
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $25,000
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )

Policy contract number

10743

Policy instance

Insurance contract or identification number	10743
Number of Individuals Covered	188
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $24,500
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,500
Insurance broker organization code?	3
Insurance broker name	HOWELL BENEFIT SERICES, INC.

GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )

Policy contract number

107029

Policy instance

Insurance contract or identification number	107029
Number of Individuals Covered	160
Insurance policy start date	2010-01-01
Insurance policy end date	2010-06-30
Total amount of commissions paid to insurance broker	USD $11,873
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,873
Insurance broker name	HOWELL BENEFITS SERVICES

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Company Name:	LUZERNE COUNTY HEAD START, INC.
Employer identification number (EIN):	232083753
NAIC Classification:	624410
NAIC Description:	Child Day Care Services