401k Plan data: CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN plan

CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN
Plan identification number	501

CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

CONSTELLATION SCHOOLS PARMA COMMUNITY has sponsored the creation of one or more 401k plans.

Company Name: CONSTELLATION SCHOOLS PARMA COMMUNITY

Employer identification number (EIN): 341911935

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-07-01 C. DAVID MASSA 2024-01-26
501 2021-10-29

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-07-01	C. DAVID MASSA	2024-01-26
501	2021-10-29

Plan Statistics for CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN

401k plan membership statisitcs for CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN

Measure Date Value
2022: CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-07-01 375
Total number of active participants reported on line 7a of the Form 5500 2022-07-01 395
Number of retired or separated participants receiving benefits 2022-07-01 0
Number of other retired or separated participants entitled to future benefits 2022-07-01 0
Total of all active and inactive participants 2022-07-01 395
Number of employers contributing to the scheme 2022-07-01 0
2021: CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-10-29 496
Total number of active participants reported on line 7a of the Form 5500 2021-10-29 372
Number of retired or separated participants receiving benefits 2021-10-29 3
Total of all active and inactive participants 2021-10-29 375
Total participants 2021-10-29 375

Measure	Date	Value
2022: CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-07-01	375
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	395
Number of retired or separated participants receiving benefits	2022-07-01	0
Number of other retired or separated participants entitled to future benefits	2022-07-01	0
Total of all active and inactive participants	2022-07-01	395
Number of employers contributing to the scheme	2022-07-01	0
2021: CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-10-29	496
Total number of active participants reported on line 7a of the Form 5500	2021-10-29	372
Number of retired or separated participants receiving benefits	2021-10-29	3
Total of all active and inactive participants	2021-10-29	375
Total participants	2021-10-29	375

Form 5500 Responses for CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN

2022: CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-07-01	Type of plan entity	Single employer plan
2022-07-01	Plan funding arrangement – Insurance	Yes
2022-07-01	Plan benefit arrangement – Insurance	Yes
2021: CONSTELLATION SCHOOLS PARMA COMMUNITY WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-10-29	Type of plan entity	Single employer plan
2021-10-29	First time form 5500 has been submitted	Yes
2021-10-29	Submission has been amended	No
2021-10-29	This submission is the final filing	No
2021-10-29	This return/report is a short plan year return/report (less than 12 months)	Yes
2021-10-29	Plan is a collectively bargained plan	No
2021-10-29	Plan funding arrangement – Insurance	Yes
2021-10-29	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

L03061

Policy instance

Insurance contract or identification number	L03061
Number of Individuals Covered	554
Insurance policy start date	2022-07-01
Insurance policy end date	2022-08-31
Total amount of commissions paid to insurance broker	USD $6,333
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $508,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,333
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

L06346

Policy instance

Insurance contract or identification number	L06346
Number of Individuals Covered	561
Insurance policy start date	2022-09-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $47,333
Total amount of fees paid to insurance company	USD $1,799
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,641,692
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $47,333
Amount paid for insurance broker fees	1799
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

CM10000924

Policy instance

Insurance contract or identification number	CM10000924
Number of Individuals Covered	395
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $2,312
Total amount of fees paid to insurance company	USD $241
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $24,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,868
Amount paid for insurance broker fees	241
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

CM10000924

Policy instance

Insurance contract or identification number	CM10000924
Number of Individuals Covered	449
Insurance policy start date	2021-10-29
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $1,471
Total amount of fees paid to insurance company	USD $375
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	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
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 $16,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,471
Amount paid for insurance broker fees	375
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

L03061

Policy instance

Insurance contract or identification number	L03061
Number of Individuals Covered	703
Insurance policy start date	2021-10-29
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $46,123
Total amount of fees paid to insurance company	USD $9,389
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	Yes
Vision Insurance Welfare Benefit	Yes
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 $2,375,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $46,123
Amount paid for insurance broker fees	9389
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

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Company Name:	CONSTELLATION SCHOOLS PARMA COMMUNITY
Employer identification number (EIN):	341911935
NAIC Classification:	611000