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SENCORPWHITE, INC. EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan NameSENCORPWHITE, INC. EMPLOYEE BENEFITS PLAN
Plan identification number 501

SENCORPWHITE, INC. EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    SENCORPWHITE, INC. has sponsored the creation of one or more 401k plans.

    Company Name:SENCORPWHITE, INC.
    Employer identification number (EIN):203442755
    NAIC Classification:333900

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan SENCORPWHITE, INC. EMPLOYEE BENEFITS PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5012019-01-01
    5012018-01-01JUSTIN EDWARDS
    5012017-01-01STEPHEN SANFORD
    5012016-01-01GREGORY MEIKLE
    5012015-01-01GREGORY MEIKLE
    5012015-01-01GREGORY MEIKLE

    Plan Statistics for SENCORPWHITE, INC. EMPLOYEE BENEFITS PLAN

    401k plan membership statisitcs for SENCORPWHITE, INC. EMPLOYEE BENEFITS PLAN

    Measure Date Value
    2019
    Total participants, beginning-of-year2019-01-01127
    Total number of active participants reported on line 7a of the Form 55002019-01-01132
    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 participants2019-01-01132
    2018
    Total participants, beginning-of-year2018-01-01192
    Total number of active participants reported on line 7a of the Form 55002018-01-01120
    Number of retired or separated participants receiving benefits2018-01-011
    Number of other retired or separated participants entitled to future benefits2018-01-011
    Total of all active and inactive participants2018-01-01122
    2017
    Total participants, beginning-of-year2017-01-01123
    Total number of active participants reported on line 7a of the Form 55002017-01-01135
    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 participants2017-01-01135
    2016
    Total participants, beginning-of-year2016-01-01112
    Total number of active participants reported on line 7a of the Form 55002016-01-01116
    Number of retired or separated participants receiving benefits2016-01-011
    Number of other retired or separated participants entitled to future benefits2016-01-010
    Total of all active and inactive participants2016-01-01117
    2015
    Total participants, beginning-of-year2015-01-01112
    Total number of active participants reported on line 7a of the Form 55002015-01-01109
    Number of retired or separated participants receiving benefits2015-01-011
    Number of other retired or separated participants entitled to future benefits2015-01-010
    Total of all active and inactive participants2015-01-01110

    Form 5500 Responses

    2019
    2019-01-01Type of plan entitySingle employer plan
    2019-01-01Submission has been amendedNo
    2019-01-01This submission is the final filingNo
    2019-01-01This return/report is a short plan year return/report (less than 12 months)No
    2019-01-01Plan is a collectively bargained planNo
    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
    2018-01-01Submission has been amendedNo
    2018-01-01This submission is the final filingNo
    2018-01-01This return/report is a short plan year return/report (less than 12 months)No
    2018-01-01Plan is a collectively bargained planNo
    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
    2017-01-01Submission has been amendedNo
    2017-01-01This submission is the final filingNo
    2017-01-01This return/report is a short plan year return/report (less than 12 months)No
    2017-01-01Plan is a collectively bargained planNo
    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
    2015-01-01First time form 5500 has been submittedYes
    2015-01-01Submission has been amendedYes
    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 funding arrangement – General assets of the sponsorYes
    2015-01-01Plan benefit arrangement – InsuranceYes
    2015-01-01Plan benefit arrangement – General assets of the sponsorYes

    Insurance Providers Used on plan

    HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
    Policy contract number1013600000
    Policy instance 6
    Insurance contract or identification number1013600000
    Number of Individuals Covered82
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $10,353
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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
    Other welfare benefits providedWELLNESS PROGRAM
    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 $524,903
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $10,353
    Insurance broker organization code?3
    HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
    Policy contract number1013600002
    Policy instance 1
    Insurance contract or identification number1013600002
    Number of Individuals Covered1
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $170
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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
    Other welfare benefits providedWELLNESS PROGRAM
    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 $8,641
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $170
    Insurance broker organization code?3
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number882635G
    Policy instance 2
    Insurance contract or identification number882635G
    Number of Individuals Covered179
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $8,328
    Total amount of fees paid to insurance companyUSD $22,552
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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 providedAD&D, SUPPLEMENTAL LIFE, DEPENDENT LIFE, SUPPLEMENTAL AD&D, EMPLOYEE ASSISTANCE PROGRAM
    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 $193,485
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,328
    Amount paid for insurance broker fees9008
    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 number00555709
    Policy instance 3
    Insurance contract or identification number00555709
    Number of Individuals Covered144
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $9,836
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
    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 $114,797
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,835
    Insurance broker organization code?3
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number30063242
    Policy instance 4
    Insurance contract or identification number30063242
    Number of Individuals Covered88
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $775
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
    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 $11,654
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $775
    Insurance broker organization code?3
    HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
    Policy contract number1013610000
    Policy instance 5
    Insurance contract or identification number1013610000
    Number of Individuals Covered186
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $23,700
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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
    Other welfare benefits providedWELLNESS PROGRAM
    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 $1,201,551
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $23,700
    Insurance broker organization code?3
    TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 )
    Policy contract number131117154128
    Policy instance 5
    Insurance contract or identification number131117154128
    Number of Individuals Covered63
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $9,921
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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
    Other welfare benefits providedWELLNESS PROGRAM
    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 $549,679
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $9,921
    Insurance broker organization code?3
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number30063242
    Policy instance 4
    Insurance contract or identification number30063242
    Number of Individuals Covered82
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $819
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
    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 $11,947
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $819
    Insurance broker organization code?3
    ALTUS DENTAL INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 52632 )
    Policy contract number1180_1
    Policy instance 3
    Insurance contract or identification number1180_1
    Number of Individuals Covered271
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $5,698
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
    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 $109,897
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,698
    Insurance broker organization code?3
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number882635G
    Policy instance 2
    Insurance contract or identification number882635G
    Number of Individuals Covered184
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $7,453
    Total amount of fees paid to insurance companyUSD $11,080
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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 providedAD&D, SUPPLEMENTAL LIFE, DEPENDENT LIFE, SUPPLEMENTAL AD&D, EMPLOYEE ASSISTANCE PROGRAM
    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 $168,437
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Amount paid for insurance broker fees11080
    Additional information about fees paid to insurance brokerFEES
    Insurance broker organization code?3
    Commission paid to Insurance BrokerUSD $7,453
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number131117154128
    Policy instance 1
    Insurance contract or identification number131117154128
    Number of Individuals Covered159
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $24,161
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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
    Other welfare benefits providedWELLNESS PROGRAM
    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 $1,347,432
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $24,161
    Insurance broker organization code?3
    TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 )
    Policy contract number131117154128
    Policy instance 5
    Insurance contract or identification number131117154128
    Number of Individuals Covered76
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $8,533
    Total amount of fees paid to insurance companyUSD $648
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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
    Other welfare benefits providedWELLNESS PROGRAM
    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 $485,766
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,533
    Amount paid for insurance broker fees648
    Additional information about fees paid to insurance brokerFEES
    Insurance broker organization code?3
    Insurance broker nameBRABO BENEFITS INC.
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number30063242
    Policy instance 4
    Insurance contract or identification number30063242
    Number of Individuals Covered90
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $823
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
    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 $12,059
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $823
    Insurance broker organization code?3
    Insurance broker nameBRABO BENEFITS INC
    ALTUS DENTAL INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 52632 )
    Policy contract number1180_1
    Policy instance 3
    Insurance contract or identification number1180_1
    Number of Individuals Covered318
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $5,713
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
    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 $110,640
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,713
    Insurance broker organization code?3
    Insurance broker nameBRABO BENEFITS, INC.
    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number00489957
    Policy instance 2
    Insurance contract or identification number00489957
    Number of Individuals Covered186
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $13,591
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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 providedAD&D, SUPPLEMENTAL LIFE, DEPENDENT LIFE, SUPPLEMENTAL AD&D, EMPLOYEE ASSISTANCE PROGRAM
    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 $164,091
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $13,591
    Insurance broker organization code?3
    Insurance broker nameBRABO BENEFITS INC
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number131117154128
    Policy instance 1
    Insurance contract or identification number131117154128
    Number of Individuals Covered189
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $23,633
    Total amount of fees paid to insurance companyUSD $1,672
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating 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
    Other welfare benefits providedWELLNESS PROGRAM
    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 $1,262,612
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $23,633
    Amount paid for insurance broker fees1672
    Additional information about fees paid to insurance brokerFEES
    Insurance broker organization code?3
    Insurance broker nameBRABO BENEFITS INC.
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number131117154128
    Policy instance 2
    Insurance contract or identification number131117154128
    Number of Individuals Covered180
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $24,531
    Total amount of fees paid to insurance companyUSD $7,449
    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
    Other welfare benefits providedWELLNESS PROGRAM
    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 $1,007,625
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $24,531
    Amount paid for insurance broker fees7449
    Additional information about fees paid to insurance brokerFEES
    Insurance broker organization code?3
    Insurance broker nameSTARKWEATHER & SHEPLEY INSURANCE
    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number00489957
    Policy instance 3
    Insurance contract or identification number00489957
    Number of Individuals Covered141
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $16,736
    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 providedAD&D, SUPPLEMENTAL LIFE, DEPENDENT LIFE, SUPPLEMENTAL AD&D, EMPLOYEE ASSISTANCE PROGRAM
    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 $129,473
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $16,736
    Insurance broker organization code?3
    Insurance broker nameBRABO BENEFITS INC
    TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 )
    Policy contract number131117154128
    Policy instance 4
    Insurance contract or identification number131117154128
    Number of Individuals Covered59
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $9,751
    Total amount of fees paid to insurance companyUSD $2,851
    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
    Other welfare benefits providedWELLNESS PROGRAM
    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 $404,281
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $9,751
    Amount paid for insurance broker fees2851
    Additional information about fees paid to insurance brokerFEES
    Insurance broker organization code?3
    Insurance broker nameSTARKWEATHER & SHEPLEY INSURANCE
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number0754034
    Policy instance 5
    Insurance contract or identification number0754034
    Number of Individuals Covered122
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    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 BenefitYes
    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 $11,466
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )
    Policy contract number00008V205
    Policy instance 1
    Insurance contract or identification number00008V205
    Number of Individuals Covered132
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $3,615
    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 BenefitYes
    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 $106,496
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,615
    Insurance broker organization code?3
    Insurance broker nameSTARKWEATHER & SHELPLEY INC

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