AUSTIN STREET CENTER has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SHELTER MINISTRIES MEDICAL AND DENTAL
| Measure | Date | Value |
|---|
| 2020: SHELTER MINISTRIES MEDICAL AND DENTAL 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-12-01 | 118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 0 |
| Number of retired or separated participants receiving benefits | 2020-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-12-01 | 0 |
| Total of all active and inactive participants | 2020-12-01 | 0 |
| Number of employers contributing to the scheme | 2020-12-01 | 0 |
| 2019: SHELTER MINISTRIES MEDICAL AND DENTAL 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-12-01 | 136 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 118 |
| Number of retired or separated participants receiving benefits | 2019-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-12-01 | 0 |
| Total of all active and inactive participants | 2019-12-01 | 118 |
| Number of employers contributing to the scheme | 2019-12-01 | 0 |
| 2018: SHELTER MINISTRIES MEDICAL AND DENTAL 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-12-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 136 |
| Number of retired or separated participants receiving benefits | 2018-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-12-01 | 0 |
| Total of all active and inactive participants | 2018-12-01 | 136 |
| Number of employers contributing to the scheme | 2018-12-01 | 0 |
| 2017: SHELTER MINISTRIES MEDICAL AND DENTAL 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-12-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 120 |
| Number of retired or separated participants receiving benefits | 2017-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-12-01 | 0 |
| Total of all active and inactive participants | 2017-12-01 | 120 |
| Number of employers contributing to the scheme | 2017-12-01 | 0 |
| 2020: SHELTER MINISTRIES MEDICAL AND DENTAL 2020 form 5500 responses |
|---|
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | This submission is the final filing | Yes |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SHELTER MINISTRIES MEDICAL AND DENTAL 2019 form 5500 responses |
|---|
| 2019-12-01 | Type of plan entity | Single employer plan |
| 2019-12-01 | Plan funding arrangement – Insurance | Yes |
| 2019-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: SHELTER MINISTRIES MEDICAL AND DENTAL 2018 form 5500 responses |
|---|
| 2018-12-01 | Type of plan entity | Single employer plan |
| 2018-12-01 | Plan funding arrangement – Insurance | Yes |
| 2018-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: SHELTER MINISTRIES MEDICAL AND DENTAL 2017 form 5500 responses |
|---|
| 2017-12-01 | Type of plan entity | Single employer plan |
| 2017-12-01 | First time form 5500 has been submitted | Yes |
| 2017-12-01 | Plan funding arrangement – Insurance | Yes |
| 2017-12-01 | Plan benefit arrangement – Insurance | Yes |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 279479 |
| Policy instance | 1 |
| Insurance contract or identification number | 279479 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Total amount of commissions paid to insurance broker | USD $59,069 | | Total amount of fees paid to insurance company | USD $3,444 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,333,625 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $59,069 | | Amount paid for insurance broker fees | 3444 | | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3343369 |
| Policy instance | 2 |
| Insurance contract or identification number | 3343369 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Total amount of commissions paid to insurance broker | USD $5,495 | | Total amount of fees paid to insurance company | USD $970 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,495 | | Amount paid for insurance broker fees | 970 | | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 279479 |
| Policy instance | 1 |
| Insurance contract or identification number | 279479 | | Number of Individuals Covered | 139 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Total amount of commissions paid to insurance broker | USD $56,292 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,169,104 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $56,292 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3343369 |
| Policy instance | 2 |
| Insurance contract or identification number | 3343369 | | Number of Individuals Covered | 118 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Total amount of commissions paid to insurance broker | USD $4,563 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,563 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 3G3139 |
| Policy instance | 1 |
| Insurance contract or identification number | 3G3139 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Total amount of commissions paid to insurance broker | USD $49,586 | | Total amount of fees paid to insurance company | USD $366 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,074,690 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,586 | | Amount paid for insurance broker fees | 366 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 506912 |
| Policy instance | 1 |
| Insurance contract or identification number | 506912 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $49,730 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,080,642 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
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