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ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 401k Plan overview

Plan NameST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN
Plan identification number 501

ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE 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

ST. IGNATIUS COLLEGE PREPARATORY has sponsored the creation of one or more 401k plans.

Company Name:ST. IGNATIUS COLLEGE PREPARATORY
Employer identification number (EIN):941451515
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01JAMES BETTENCOURT2023-06-30
5012021-01-01JAMES BETTENCOURT2022-06-23
5012020-01-01JAMES BETTENCOURT2021-04-27
5012020-01-01JAMES BETTENCOURT2022-03-10
5012019-01-01JAMES BETTENCOURT2020-07-20
5012019-01-01JAMES BETTENCOURT2022-03-10
5012018-01-01
5012018-01-01JAMES BETTENCOURT2022-03-10
5012017-01-01
5012017-01-01JAMES BETTENCOURT2022-03-10
5012017-01-01JAMES BETTENCOURT2022-03-10
5012016-01-01JAMES BETTENCOURT
5012016-01-01JAMES BETTENCOURT2022-03-17
5012015-01-01SHAINA A LYNCH
5012014-01-01SHAINA LYNCH
5012013-01-01SHAINA LYNCH
5012012-01-01SHAINA LYNCH
5012011-01-01SHAINA LYNCH
5012010-01-01SHAINA LYNCH
5012009-01-01SHAINA LYNCH
5012008-01-01SHAINA LYNCH
5012007-01-01SHAINA LYNCH
5012006-01-01SHAINA LYNCH
5012005-01-01SHAINA LYNCH
5012004-01-01SHAINA LYNCH
5012003-01-01SHAINA LYNCH
5012002-01-01SHAINA LYNCH
5012001-01-01SHAINA LYNCH
5012000-01-01SHAINA LYNCH
5011999-01-01SHAINA LYNCH
5011998-01-01SHAINA LYNCH
5011997-01-01SHAINA LYNCH
5011996-01-01SHAINA LYNCH

Plan Statistics for ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN

401k plan membership statisitcs for ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN

Measure Date Value
2022: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01263
Total number of active participants reported on line 7a of the Form 55002022-01-01272
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01272
Number of employers contributing to the scheme2022-01-010
2021: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01204
Total number of active participants reported on line 7a of the Form 55002021-01-01263
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01263
Number of employers contributing to the scheme2021-01-010
2020: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01205
Total number of active participants reported on line 7a of the Form 55002020-01-01204
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01204
Number of employers contributing to the scheme2020-01-010
2019: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01205
Total number of active participants reported on line 7a of the Form 55002019-01-01205
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01205
Number of employers contributing to the scheme2019-01-010
2018: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01201
Total number of active participants reported on line 7a of the Form 55002018-01-01200
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01200
Number of employers contributing to the scheme2018-01-010
2017: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01197
Total number of active participants reported on line 7a of the Form 55002017-01-01201
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01201
Number of employers contributing to the scheme2017-01-010
2016: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01203
Total number of active participants reported on line 7a of the Form 55002016-01-01197
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01200
Number of employers contributing to the scheme2016-01-010
2015: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01204
Total number of active participants reported on line 7a of the Form 55002015-01-01203
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01203
2014: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01204
Total number of active participants reported on line 7a of the Form 55002014-01-01204
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01204
2013: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01179
Total number of active participants reported on line 7a of the Form 55002013-01-01187
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01187
2012: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01180
Total number of active participants reported on line 7a of the Form 55002012-01-01179
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01179
2011: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01173
Total number of active participants reported on line 7a of the Form 55002011-01-01180
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01180
2010: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01173
Total number of active participants reported on line 7a of the Form 55002010-01-01173
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01173
2009: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01168
Total number of active participants reported on line 7a of the Form 55002009-01-01173
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01173
2008: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01168
Total number of active participants reported on line 7a of the Form 55002008-01-01168
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-010
Total of all active and inactive participants2008-01-01168
2007: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01159
Total number of active participants reported on line 7a of the Form 55002007-01-01168
Number of retired or separated participants receiving benefits2007-01-010
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-01168
2006: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01160
Total number of active participants reported on line 7a of the Form 55002006-01-01159
Number of retired or separated participants receiving benefits2006-01-010
Number of other retired or separated participants entitled to future benefits2006-01-010
Total of all active and inactive participants2006-01-01159
2005: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01154
Total number of active participants reported on line 7a of the Form 55002005-01-01160
Number of retired or separated participants receiving benefits2005-01-010
Number of other retired or separated participants entitled to future benefits2005-01-010
Total of all active and inactive participants2005-01-01160
2004: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01153
Total number of active participants reported on line 7a of the Form 55002004-01-01154
Number of retired or separated participants receiving benefits2004-01-010
Number of other retired or separated participants entitled to future benefits2004-01-010
Total of all active and inactive participants2004-01-01154
2003: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01145
Total number of active participants reported on line 7a of the Form 55002003-01-01153
Number of retired or separated participants receiving benefits2003-01-010
Number of other retired or separated participants entitled to future benefits2003-01-010
Total of all active and inactive participants2003-01-01153
2002: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-01141
Total number of active participants reported on line 7a of the Form 55002002-01-01145
Number of retired or separated participants receiving benefits2002-01-010
Number of other retired or separated participants entitled to future benefits2002-01-010
Total of all active and inactive participants2002-01-01145
2001: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2001 401k membership
Total participants, beginning-of-year2001-01-01136
Total number of active participants reported on line 7a of the Form 55002001-01-01141
Number of retired or separated participants receiving benefits2001-01-010
Number of other retired or separated participants entitled to future benefits2001-01-010
Total of all active and inactive participants2001-01-01141
2000: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2000 401k membership
Total participants, beginning-of-year2000-01-01129
Total number of active participants reported on line 7a of the Form 55002000-01-01136
Number of retired or separated participants receiving benefits2000-01-010
Number of other retired or separated participants entitled to future benefits2000-01-010
Total of all active and inactive participants2000-01-01136
1999: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 1999 401k membership
Total participants, beginning-of-year1999-01-01127
Total number of active participants reported on line 7a of the Form 55001999-01-01129
Number of retired or separated participants receiving benefits1999-01-010
Number of other retired or separated participants entitled to future benefits1999-01-010
Total of all active and inactive participants1999-01-01129
1998: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 1998 401k membership
Total participants, beginning-of-year1998-01-01122
Total number of active participants reported on line 7a of the Form 55001998-01-01127
Number of retired or separated participants receiving benefits1998-01-010
Number of other retired or separated participants entitled to future benefits1998-01-010
Total of all active and inactive participants1998-01-01127
1997: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 1997 401k membership
Total participants, beginning-of-year1997-01-01100
Total number of active participants reported on line 7a of the Form 55001997-01-01122
Number of retired or separated participants receiving benefits1997-01-010
Number of other retired or separated participants entitled to future benefits1997-01-010
Total of all active and inactive participants1997-01-01122
1996: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 1996 401k membership
Total participants, beginning-of-year1996-01-01100
Total number of active participants reported on line 7a of the Form 55001996-01-01100
Number of retired or separated participants receiving benefits1996-01-010
Number of other retired or separated participants entitled to future benefits1996-01-010
Total of all active and inactive participants1996-01-01100

Form 5500 Responses for ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN

2022: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedYes
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedYes
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes
2006: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – InsuranceYes
2005: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedNo
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – InsuranceYes
2004: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedNo
2004-01-01This submission is the final filingNo
2004-01-01This return/report is a short plan year return/report (less than 12 months)No
2004-01-01Plan is a collectively bargained planNo
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – InsuranceYes
2003: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2003 form 5500 responses
2003-01-01Type of plan entitySingle employer plan
2003-01-01Submission has been amendedNo
2003-01-01This submission is the final filingNo
2003-01-01This return/report is a short plan year return/report (less than 12 months)No
2003-01-01Plan is a collectively bargained planNo
2003-01-01Plan funding arrangement – InsuranceYes
2003-01-01Plan benefit arrangement – InsuranceYes
2002: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2002 form 5500 responses
2002-01-01Type of plan entitySingle employer plan
2002-01-01Submission has been amendedNo
2002-01-01This submission is the final filingNo
2002-01-01This return/report is a short plan year return/report (less than 12 months)No
2002-01-01Plan is a collectively bargained planNo
2002-01-01Plan funding arrangement – InsuranceYes
2002-01-01Plan benefit arrangement – InsuranceYes
2001: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2001 form 5500 responses
2001-01-01Type of plan entitySingle employer plan
2001-01-01Submission has been amendedNo
2001-01-01This submission is the final filingNo
2001-01-01This return/report is a short plan year return/report (less than 12 months)No
2001-01-01Plan is a collectively bargained planNo
2001-01-01Plan funding arrangement – InsuranceYes
2001-01-01Plan benefit arrangement – InsuranceYes
2000: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 2000 form 5500 responses
2000-01-01Type of plan entitySingle employer plan
2000-01-01Submission has been amendedNo
2000-01-01This submission is the final filingNo
2000-01-01This return/report is a short plan year return/report (less than 12 months)No
2000-01-01Plan is a collectively bargained planNo
2000-01-01Plan funding arrangement – InsuranceYes
2000-01-01Plan benefit arrangement – InsuranceYes
1999: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 1999 form 5500 responses
1999-01-01Type of plan entitySingle employer plan
1999-01-01Submission has been amendedNo
1999-01-01This submission is the final filingNo
1999-01-01This return/report is a short plan year return/report (less than 12 months)No
1999-01-01Plan is a collectively bargained planNo
1999-01-01Plan funding arrangement – InsuranceYes
1999-01-01Plan benefit arrangement – InsuranceYes
1998: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 1998 form 5500 responses
1998-01-01Type of plan entitySingle employer plan
1998-01-01Submission has been amendedNo
1998-01-01This submission is the final filingNo
1998-01-01This return/report is a short plan year return/report (less than 12 months)No
1998-01-01Plan is a collectively bargained planNo
1998-01-01Plan funding arrangement – InsuranceYes
1998-01-01Plan benefit arrangement – InsuranceYes
1997: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 1997 form 5500 responses
1997-01-01Type of plan entitySingle employer plan
1997-01-01Submission has been amendedNo
1997-01-01This submission is the final filingNo
1997-01-01This return/report is a short plan year return/report (less than 12 months)No
1997-01-01Plan is a collectively bargained planNo
1997-01-01Plan funding arrangement – InsuranceYes
1997-01-01Plan benefit arrangement – InsuranceYes
1996: ST. IGNATIUS COLLEGE PREPARATORY EMPLOYEE FLEXIBLE BENEFIT PLAN 1996 form 5500 responses
1996-01-01Type of plan entitySingle employer plan
1996-01-01First time form 5500 has been submittedYes
1996-01-01Submission has been amendedNo
1996-01-01This submission is the final filingNo
1996-01-01This return/report is a short plan year return/report (less than 12 months)No
1996-01-01Plan is a collectively bargained planNo
1996-01-01Plan funding arrangement – InsuranceYes
1996-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number892409G
Policy instance 5
Insurance contract or identification number892409G
Number of Individuals Covered216
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,543
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $30,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,063
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number922606
Policy instance 4
Insurance contract or identification number922606
Number of Individuals Covered171
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $49,089
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,322,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,089
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5380047
Policy instance 3
Insurance contract or identification number5380047
Number of Individuals Covered640
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $25,035
Total amount of fees paid to insurance companyUSD $4,210
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $290,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,373
Amount paid for insurance broker fees4210
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number4089
Policy instance 2
Insurance contract or identification number4089
Number of Individuals Covered215
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 $1,462,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number12185978
Policy instance 1
Insurance contract or identification number12185978
Number of Individuals Covered194
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,636
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,055
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number12185978
Policy instance 1
Insurance contract or identification number12185978
Number of Individuals Covered201
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,315
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,315
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number4089
Policy instance 2
Insurance contract or identification number4089
Number of Individuals Covered202
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 $1,103,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5380047
Policy instance 3
Insurance contract or identification number5380047
Number of Individuals Covered619
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $21,754
Total amount of fees paid to insurance companyUSD $7,600
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $267,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,258
Amount paid for insurance broker fees2644
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number922606
Policy instance 4
Insurance contract or identification number922606
Number of Individuals Covered66
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $69,326
Total amount of fees paid to insurance companyUSD $8,950
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,381,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $69,326
Amount paid for insurance broker fees8950
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number892409G
Policy instance 5
Insurance contract or identification number892409G
Number of Individuals Covered205
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,526
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $30,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,526
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5380047
Policy instance 5
Insurance contract or identification number5380047
Number of Individuals Covered621
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $22,779
Total amount of fees paid to insurance companyUSD $8,856
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $255,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,753
Amount paid for insurance broker fees5101
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0067670
Policy instance 4
Insurance contract or identification numberW0067670
Number of Individuals Covered182
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $65,130
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,223,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees65130
Additional information about fees paid to insurance brokerPRODUCER SERVICE FEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number494708
Policy instance 3
Insurance contract or identification number494708
Number of Individuals Covered204
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,784
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $33,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,784
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number4089
Policy instance 2
Insurance contract or identification number4089
Number of Individuals Covered208
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 $1,085,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number12185978
Policy instance 1
Insurance contract or identification number12185978
Number of Individuals Covered202
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,306
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,596
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,306
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number12185978
Policy instance 1
Insurance contract or identification number12185978
Number of Individuals Covered203
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,304
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,304
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number4089
Policy instance 2
Insurance contract or identification number4089
Number of Individuals Covered18
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $100
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $98,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees100
Additional information about fees paid to insurance brokerLBG BOB BONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number494708
Policy instance 3
Insurance contract or identification number494708
Number of Individuals Covered213
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $18,517
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $96,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,517
Amount paid for insurance broker fees0
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0067670
Policy instance 4
Insurance contract or identification numberW0067670
Number of Individuals Covered188
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $58,522
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,111,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees58522
Additional information about fees paid to insurance brokerPRODUCER SERVICE FEES
Insurance broker organization code?3
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract numberN7118A
Policy instance 4
Insurance contract or identification numberN7118A
Number of Individuals Covered84
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $72,401
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,508,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $72,401
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number12185978
Policy instance 1
Insurance contract or identification number12185978
Number of Individuals Covered199
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,274
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,274
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number4089
Policy instance 2
Insurance contract or identification number4089
Number of Individuals Covered182
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 $1,179,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number494708
Policy instance 3
Insurance contract or identification number494708
Number of Individuals Covered205
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $17,370
Total amount of fees paid to insurance companyUSD $0
Dental 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 $83,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,370
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number4089
Policy instance 2
Insurance contract or identification number4089
Number of Individuals Covered163
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 $1,051,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number494708
Policy instance 3
Insurance contract or identification number494708
Number of Individuals Covered201
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $17,569
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $84,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,569
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMOC INSURANCE SERVICES
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract numberN7118A
Policy instance 4
Insurance contract or identification numberN7118A
Number of Individuals Covered85
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $71,027
Total amount of fees paid to insurance companyUSD $10,000
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,373,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,027
Amount paid for insurance broker fees10000
Additional information about fees paid to insurance brokerBONUS NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameMOC INSURANCE SERVICES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number12185978
Policy instance 1
Insurance contract or identification number12185978
Number of Individuals Covered194
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,243
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,243
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMOC INSURANCE SERVICES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number494708
Policy instance 5
Insurance contract or identification number494708
Number of Individuals Covered209
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $17,575
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $84,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,575
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number12185978
Policy instance 4
Insurance contract or identification number12185978
Number of Individuals Covered197
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $1,252
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,252
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number4089
Policy instance 3
Insurance contract or identification number4089
Number of Individuals Covered177
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
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 $1,032,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number805822HNO
Policy instance 2
Insurance contract or identification number805822HNO
Number of Individuals Covered148
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $61,957
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,238,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,957
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number805822
Policy instance 1
Insurance contract or identification number805822
Number of Individuals Covered46
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $25,947
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $520,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,947
Amount paid for insurance broker fees0
Insurance broker organization code?3

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