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WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 401k Plan overview

Plan NameWESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN
Plan identification number 501

WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT 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)
  • Other welfare benefit cover

401k Sponsoring company profile

WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF has sponsored the creation of one or more 401k plans.

Company Name:WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF
Employer identification number (EIN):251095386
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-07-01
5012020-07-01
5012019-07-01
5012018-07-01
5012017-07-01BARBARA MANNING BARBARA MANNING2018-12-14
5012016-07-01BARBARA MANNING BARBARA MANNING2017-12-07
5012015-07-01
5012014-07-01
5012013-07-01
5012012-07-01MARY LOU RAIBLE MARY LOU RAIBLE2014-03-26
5012011-07-01MARY LOU RAIBLE MARY LOU RAIBLE2013-03-26
5012010-07-01MARY LOU RAIBLE
5012009-07-01TIMOTHY HARRIS

Plan Statistics for WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN

401k plan membership statisitcs for WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN

Measure Date Value
2021: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01198
Total number of active participants reported on line 7a of the Form 55002021-07-01186
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01186
2020: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01196
Total number of active participants reported on line 7a of the Form 55002020-07-01188
Number of retired or separated participants receiving benefits2020-07-0110
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01198
2019: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01229
Total number of active participants reported on line 7a of the Form 55002019-07-01234
Number of retired or separated participants receiving benefits2019-07-013
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01237
2018: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01224
Total number of active participants reported on line 7a of the Form 55002018-07-01227
Number of retired or separated participants receiving benefits2018-07-012
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01229
2017: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01200
Total number of active participants reported on line 7a of the Form 55002017-07-01224
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01224
2016: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01213
Total number of active participants reported on line 7a of the Form 55002016-07-01200
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01200
2015: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01215
Total number of active participants reported on line 7a of the Form 55002015-07-01213
Total of all active and inactive participants2015-07-01213
2014: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01219
Total number of active participants reported on line 7a of the Form 55002014-07-01215
Number of retired or separated participants receiving benefits2014-07-014
Total of all active and inactive participants2014-07-01219
2013: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01217
Total number of active participants reported on line 7a of the Form 55002013-07-01215
Number of retired or separated participants receiving benefits2013-07-014
Total of all active and inactive participants2013-07-01219
Total participants2013-07-01219
2012: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01214
Total number of active participants reported on line 7a of the Form 55002012-07-01199
Number of retired or separated participants receiving benefits2012-07-0118
Total of all active and inactive participants2012-07-01217
Total participants2012-07-01217
2011: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01217
Total number of active participants reported on line 7a of the Form 55002011-07-01196
Number of retired or separated participants receiving benefits2011-07-0118
Total of all active and inactive participants2011-07-01214
Total participants2011-07-01214
2010: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-01216
Total number of active participants reported on line 7a of the Form 55002010-07-01194
Number of retired or separated participants receiving benefits2010-07-0123
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01217
Total participants2010-07-01217
Number of employers contributing to the scheme2010-07-010
2009: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01194
Total number of active participants reported on line 7a of the Form 55002009-07-01192
Number of retired or separated participants receiving benefits2009-07-0124
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01216
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-01216
Number of participants with account balances2009-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010
Number of employers contributing to the scheme2009-07-010

Financial Data on WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN

Measure Date Value
2022 : WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$395,327
Total income from all sources (including contributions)2022-06-30$3,496,410
Total loss/gain on sale of assets2022-06-30$0
Total of all expenses incurred2022-06-30$3,453,701
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$3,314,994
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$3,496,165
Value of total assets at end of year2022-06-30$67,307
Value of total assets at beginning of year2022-06-30$419,925
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$138,707
Total interest from all sources2022-06-30$245
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Administrative expenses professional fees incurred2022-06-30$138,707
Was this plan covered by a fidelity bond2022-06-30Yes
Value of fidelity bond cover2022-06-30$500,000
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Contributions received from participants2022-06-30$728,753
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-06-30$50,792
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-06-30$378,567
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net income/loss2022-06-30$42,709
Value of net assets at end of year (total assets less liabilities)2022-06-30$67,307
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$24,598
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-06-30$16,515
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-06-30$41,358
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-06-30$41,358
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-06-30$245
Expenses. Payments to insurance carriers foe the provision of benefits2022-06-30$734,476
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30No
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$2,767,412
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-06-30$2,580,518
Liabilities. Value of benefit claims payable at end of year2022-06-30$0
Liabilities. Value of benefit claims payable at beginning of year2022-06-30$395,327
Did the plan have assets held for investment2022-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Opinion of an independent qualified public accountant for this plan2022-06-30Unqualified
Accountancy firm name2022-06-30SCHNEIDER DOWNS & CO., INC.
Accountancy firm EIN2022-06-30251408703
2021 : WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$395,327
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total income from all sources (including contributions)2021-06-30$2,581,376
Total loss/gain on sale of assets2021-06-30$0
Total of all expenses incurred2021-06-30$2,556,778
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-06-30$2,423,195
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-06-30$2,581,174
Value of total assets at end of year2021-06-30$419,925
Value of total assets at beginning of year2021-06-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-06-30$133,583
Total interest from all sources2021-06-30$202
Total dividends received (eg from common stock, registered investment company shares)2021-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-06-30No
Administrative expenses professional fees incurred2021-06-30$133,583
Was this plan covered by a fidelity bond2021-06-30Yes
Value of fidelity bond cover2021-06-30$500,000
If this is an individual account plan, was there a blackout period2021-06-30No
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Contributions received from participants2021-06-30$578,959
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-06-30$378,567
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net income/loss2021-06-30$24,598
Value of net assets at end of year (total assets less liabilities)2021-06-30$24,598
Value of net assets at beginning of year (total assets less liabilities)2021-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-06-30$41,358
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-06-30$202
Expenses. Payments to insurance carriers foe the provision of benefits2021-06-30$550,217
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30No
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Contributions received in cash from employer2021-06-30$2,002,215
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-06-30$1,872,978
Liabilities. Value of benefit claims payable at end of year2021-06-30$395,327
Liabilities. Value of benefit claims payable at beginning of year2021-06-30$0
Did the plan have assets held for investment2021-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
Opinion of an independent qualified public accountant for this plan2021-06-30Unqualified
Accountancy firm name2021-06-30SCHNEIDER DOWNS & CO., INC.
Accountancy firm EIN2021-06-30251408703

Form 5500 Responses for WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN

2021: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2019: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: WESTERN PENNSYLVANIA SCHOOL FOR THE DEAF BENEFIT PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number31000169
Policy instance 1
Insurance contract or identification number31000169
Number of Individuals Covered186
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $734,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number229301
Policy instance 2
Insurance contract or identification number229301
Number of Individuals Covered496
Insurance policy start date2020-07-01
Insurance policy end date2020-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $487,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number31000169
Policy instance 1
Insurance contract or identification number31000169
Number of Individuals Covered198
Insurance policy start date2020-09-01
Insurance policy end date2021-06-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $550,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number4304
Policy instance 7
Insurance contract or identification number4304
Number of Individuals Covered210
Insurance policy start date2019-09-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $1,011
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,011
Insurance broker organization code?3
BACK ON TRACK EMPLOYEE ASSISTANCE PROGRAM (National Association of Insurance Commissioners NAIC id number: 62322 )
Policy contract numberN/A
Policy instance 6
Insurance contract or identification numberN/A
Number of Individuals Covered231
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $9,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number021055904
Policy instance 5
Insurance contract or identification number021055904
Number of Individuals Covered7
Insurance policy start date2019-07-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number021055304
Policy instance 4
Insurance contract or identification number021055304
Number of Individuals Covered411
Insurance policy start date2019-07-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $631,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number921739-00,099
Policy instance 3
Insurance contract or identification number921739-00,099
Number of Individuals Covered547
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $13,583
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $135,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,583
Insurance broker organization code?3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number229301
Policy instance 2
Insurance contract or identification number229301
Number of Individuals Covered499
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $2,880
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,809,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,880
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number932191
Policy instance 1
Insurance contract or identification number932191
Number of Individuals Covered234
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $15,098
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $68,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,098
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number921739-00,099
Policy instance 3
Insurance contract or identification number921739-00,099
Number of Individuals Covered539
Insurance policy start date2018-09-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $11,557
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $115,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,557
Insurance broker organization code?3
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number021055904
Policy instance 5
Insurance contract or identification number021055904
Number of Individuals Covered0
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $190
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $190
Insurance broker organization code?3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number229301
Policy instance 2
Insurance contract or identification number229301
Number of Individuals Covered148
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $651,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG#4037352-556
Policy instance 1
Insurance contract or identification numberG#4037352-556
Number of Individuals Covered227
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $14,703
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $66,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,703
Insurance broker organization code?3
BACK ON TRACK EMPLOYEE ASSISTANCE PROGRAM (National Association of Insurance Commissioners NAIC id number: 62322 )
Policy contract numberN/A
Policy instance 6
Insurance contract or identification numberN/A
Number of Individuals Covered231
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $9,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5485682
Policy instance 7
Insurance contract or identification number5485682
Number of Individuals Covered0
Insurance policy start date2018-07-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $207
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $207
Insurance broker organization code?3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number4304
Policy instance 8
Insurance contract or identification number4304
Number of Individuals Covered225
Insurance policy start date2018-09-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $513
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $513
Insurance broker organization code?3
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number021055304
Policy instance 4
Insurance contract or identification number021055304
Number of Individuals Covered379
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $41,237
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,367,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,237
Insurance broker organization code?3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number01790249
Policy instance 3
Insurance contract or identification number01790249
Number of Individuals Covered105
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $580,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number01760416
Policy instance 2
Insurance contract or identification number01760416
Number of Individuals Covered0
Insurance policy start date2017-07-01
Insurance policy end date2017-08-31
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 $1,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number4304
Policy instance 9
Insurance contract or identification number4304
Number of Individuals Covered213
Insurance policy start date2017-09-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $797
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $441
Insurance broker organization code?3
Insurance broker nameCOURY HEALTH SERVICES INC
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number908202-000,099
Policy instance 4
Insurance contract or identification number908202-000,099
Number of Individuals Covered0
Insurance policy start date2017-07-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $2,216
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,216
Insurance broker organization code?3
Insurance broker nameSIMPSON MCCRADY BENEFITS LLC
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number021055304
Policy instance 5
Insurance contract or identification number021055304
Number of Individuals Covered385
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,302,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number21055904
Policy instance 6
Insurance contract or identification number21055904
Number of Individuals Covered0
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BACK ON TRACK EMPLOYEE ASSISTANCE PROGRAM (National Association of Insurance Commissioners NAIC id number: 62322 )
Policy contract numberN/A
Policy instance 7
Insurance contract or identification numberN/A
Number of Individuals Covered224
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $7,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5485682
Policy instance 8
Insurance contract or identification number5485682
Number of Individuals Covered334
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $4,052
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $126,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,048
Insurance broker organization code?3
Insurance broker nameCOURY HEALTH SERVICES INC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG#4037352-556
Policy instance 1
Insurance contract or identification numberG#4037352-556
Number of Individuals Covered226
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $15,408
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $70,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,408
Insurance broker organization code?3
Insurance broker nameISM INSURANCE, INC.

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