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ROGERS AND GRAY WELFARE BENEFIT PLAN 401k Plan overview

Plan NameROGERS AND GRAY WELFARE BENEFIT PLAN
Plan identification number 501

ROGERS AND GRAY WELFARE BENEFIT PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    ROGERS & GRAY INSURANCE AGENCY, INC. has sponsored the creation of one or more 401k plans.

    Company Name:ROGERS & GRAY INSURANCE AGENCY, INC.
    Employer identification number (EIN):042254905
    NAIC Classification:524210
    NAIC Description:Insurance Agencies and Brokerages

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan ROGERS AND GRAY WELFARE BENEFIT PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5012019-01-01ALLISON MCEACHERN2020-05-01
    5012018-01-01
    5012017-01-01
    5012016-01-01DAVID ROBINSON DAVID ROBINSON2017-10-03
    5012015-01-01ERIN VIEHL
    5012015-01-01
    5012014-01-01ERIN B VIEHL
    5012014-01-01ALLISON MCEACHERN

    Plan Statistics for ROGERS AND GRAY WELFARE BENEFIT PLAN

    401k plan membership statisitcs for ROGERS AND GRAY WELFARE BENEFIT PLAN

    Measure Date Value
    2019
    Total participants, beginning-of-year2019-01-01146
    Total number of active participants reported on line 7a of the Form 55002019-01-01157
    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 participants2019-01-01157
    Number of employers contributing to the scheme2019-01-010
    2018
    Total participants, beginning-of-year2018-01-01148
    Total number of active participants reported on line 7a of the Form 55002018-01-01146
    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 participants2018-01-01146
    Number of employers contributing to the scheme2018-01-010
    2017
    Total participants, beginning-of-year2017-01-01145
    Total number of active participants reported on line 7a of the Form 55002017-01-01148
    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 participants2017-01-01148
    2016
    Total participants, beginning-of-year2016-01-01124
    Total number of active participants reported on line 7a of the Form 55002016-01-01145
    Number of retired or separated participants receiving benefits2016-01-010
    Number of other retired or separated participants entitled to future benefits2016-01-010
    Total of all active and inactive participants2016-01-01145
    2015
    Total participants, beginning-of-year2015-01-01123
    Total number of active participants reported on line 7a of the Form 55002015-01-01124
    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 participants2015-01-01124
    2014
    Total participants, beginning-of-year2014-01-01100
    Total number of active participants reported on line 7a of the Form 55002014-01-01123
    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 participants2014-01-01123

    Form 5500 Responses

    2019
    2019-01-01Type of plan entitySingle employer plan
    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
    2018-01-01Type of plan entitySingle employer plan
    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
    2017-01-01Type of plan entitySingle employer plan
    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
    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
    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
    2014-01-01Type of plan entitySingle employer plan
    2014-01-01First time form 5500 has been submittedYes
    2014-01-01Submission has been amendedYes
    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 funding arrangement – General assets of the sponsorYes
    2014-01-01Plan benefit arrangement – InsuranceYes
    2014-01-01Plan benefit arrangement – General assets of the sponsorYes

    Insurance Providers Used on plan

    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number10236006
    Policy instance 3
    Insurance contract or identification number10236006
    Number of Individuals Covered157
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $10,569
    Total amount of fees paid to insurance companyUSD $3,443
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Welfare Benefit Premiums Paid to CarrierUSD $86,069
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $10,569
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Additional information about fees paid to insurance brokerOVERRIDES
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number98400831001
    Policy instance 2
    Insurance contract or identification number98400831001
    Number of Individuals Covered118
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $752
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $8,774
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $752
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4958275
    Policy instance 1
    Insurance contract or identification number4958275
    Number of Individuals Covered199
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $752
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $100,271
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $752
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010236006
    Policy instance 3
    Insurance contract or identification number000010236006
    Number of Individuals Covered146
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $9,298
    Total amount of fees paid to insurance companyUSD $6,066
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Welfare Benefit Premiums Paid to CarrierUSD $76,029
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $9,298
    Amount paid for insurance broker fees3025
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number9840083
    Policy instance 2
    Insurance contract or identification number9840083
    Number of Individuals Covered104
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $795
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $9,246
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $795
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4958275
    Policy instance 1
    Insurance contract or identification number4958275
    Number of Individuals Covered189
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $3,966
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $91,684
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,966
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number98400831001
    Policy instance 4
    Insurance contract or identification number98400831001
    Number of Individuals Covered70
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $710
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $8,158
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $710
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameROGERS AND GRAY INSURANCE AGENCY
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4958275
    Policy instance 3
    Insurance contract or identification number4958275
    Number of Individuals Covered210
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $31,135
    Total amount of fees paid to insurance companyUSD $4,120
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $0
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $31,135
    Amount paid for insurance broker fees4120
    Additional information about fees paid to insurance brokerOTHER COMMISSION
    Insurance broker organization code?3
    Insurance broker nameROGERS AND GRAY INSURANCE AGENCY
    DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
    Policy contract number95087029
    Policy instance 2
    Insurance contract or identification number95087029
    Number of Individuals Covered167
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $3,703
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $84,330
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,703
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameROGERS AND GRAY INSURANCE AGENCY
    BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
    Policy contract numberG-54241
    Policy instance 1
    Insurance contract or identification numberG-54241
    Number of Individuals Covered148
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $13,095
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Welfare Benefit Premiums Paid to CarrierUSD $129,454
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $13,095
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameROGERS AND GRAY INSURANCE AGENCY
    BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
    Policy contract numberG54241
    Policy instance 2
    Insurance contract or identification numberG54241
    Number of Individuals Covered124
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $11,567
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    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 BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    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 $112,714
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $11,567
    Insurance broker organization code?3
    Insurance broker nameROGERS AND GRAY INSURANCE AGENCY
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number111205092246
    Policy instance 1
    Insurance contract or identification number111205092246
    Number of Individuals Covered198
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $26,211
    Total amount of fees paid to insurance companyUSD $4,564
    Are there contracts with allocated funds for individual policies?No
    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 $1,107,942
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $26,211
    Amount paid for insurance broker fees4564
    Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameROGERS AND GRAY INSURANCE AGENCY
    BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
    Policy contract numberG54241
    Policy instance 2
    Insurance contract or identification numberG54241
    Number of Individuals Covered123
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $10,290
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    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 BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    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 $100,865
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $10,290
    Insurance broker organization code?3
    Insurance broker nameROGERS AND GRAY INSURANCE AGENCY
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number111205092246
    Policy instance 1
    Insurance contract or identification number111205092246
    Number of Individuals Covered205
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $30,619
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    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 $1,163,628
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $30,619
    Insurance broker organization code?3
    Insurance broker nameROGERS AND GRAY INSURANCE AGENCY

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