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HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN 401k Plan overview

Plan NameHEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN
Plan identification number 502

HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

HEBRON CHRISTIAN ACADEMY has sponsored the creation of one or more 401k plans.

Company Name:HEBRON CHRISTIAN ACADEMY
Employer identification number (EIN):582469629
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-09-01CINDY R. MOYER2023-04-13
5022020-09-01CINDY R. MOYER2022-12-15
5022018-09-01CINDY R. MOYER2022-12-15

Plan Statistics for HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN

401k plan membership statisitcs for HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN

Measure Date Value
2021: HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01150
Total number of active participants reported on line 7a of the Form 55002021-09-01135
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01135
Number of employers contributing to the scheme2021-09-010
2020: HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01125
Total number of active participants reported on line 7a of the Form 55002020-09-01134
Number of retired or separated participants receiving benefits2020-09-010
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01134
Number of employers contributing to the scheme2020-09-010
2018: HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01128
Total number of active participants reported on line 7a of the Form 55002018-09-01117
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01117
Number of employers contributing to the scheme2018-09-010

Form 5500 Responses for HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN

2021: HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2018: HEBRON CHRISTIAN ACADEMY ANCILLARY WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01First time form 5500 has been submittedYes
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number552681
Policy instance 1
Insurance contract or identification number552681
Number of Individuals Covered160
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $18,689
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $157,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,689
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number552681
Policy instance 1
Insurance contract or identification number552681
Number of Individuals Covered150
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $15,778
Total amount of fees paid to insurance companyUSD $6,826
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $134,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,655
Amount paid for insurance broker fees6826
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number552681
Policy instance 1
Insurance contract or identification number552681
Number of Individuals Covered117
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $12,974
Total amount of fees paid to insurance companyUSD $2,119
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $105,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,116
Amount paid for insurance broker fees2119
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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