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JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameJOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN
Plan identification number 501

JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

JOHN MORIARTY AND ASSOCIATES, INC. has sponsored the creation of one or more 401k plans.

Company Name:JOHN MORIARTY AND ASSOCIATES, INC.
Employer identification number (EIN):042852561
NAIC Classification:236110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-10-01
5012021-10-01
5012020-10-01JUSTIN AMICO2022-06-10
5012019-10-01LOUIS DAHAN2021-03-23
5012018-10-01LOUIS A. DAHAN2020-04-15
5012017-10-01LOUIS A. DAHAN2019-04-03
5012016-10-01
5012015-10-01
5012014-10-01
5012013-10-23LOUIS A DAHAN
5012012-10-23LOUIS DAHAN
5012011-10-23LOUIS DAHAN
5012010-10-23LOUIS DAHAN
5012009-10-23LOUIS DAHAN
5012008-10-23LOUIS DAHAN
5012007-10-23LOUIS DAHAN
5012006-10-23LOUIS DAHAN
5012005-10-23LOUIS DAHAN
5012004-10-23LOUIS DAHAN
5012003-10-23LOUIS DAHAN
5012002-10-23LOUIS DAHAN
5012001-10-23LOUIS DAHAN
5012000-10-23LOUIS DAHAN
5011999-10-23LOUIS DAHAN
5011998-10-23LOUIS DAHAN
5011997-10-23LOUIS DAHAN

Plan Statistics for JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN

Measure Date Value
2022: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-01557
Total number of active participants reported on line 7a of the Form 55002022-10-01564
Number of retired or separated participants receiving benefits2022-10-0113
Number of other retired or separated participants entitled to future benefits2022-10-010
Total of all active and inactive participants2022-10-01577
2021: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01568
Total number of active participants reported on line 7a of the Form 55002021-10-01580
Number of retired or separated participants receiving benefits2021-10-0112
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01592
2020: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01530
Total number of active participants reported on line 7a of the Form 55002020-10-01518
Number of retired or separated participants receiving benefits2020-10-0112
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01530
Number of employers contributing to the scheme2020-10-010
2019: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01522
Total number of active participants reported on line 7a of the Form 55002019-10-01535
Number of retired or separated participants receiving benefits2019-10-015
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01540
2018: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01444
Total number of active participants reported on line 7a of the Form 55002018-10-01522
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01522
2017: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01405
Total number of active participants reported on line 7a of the Form 55002017-10-01444
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01444
2016: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01408
Total number of active participants reported on line 7a of the Form 55002016-10-01405
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01405
2015: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01392
Total number of active participants reported on line 7a of the Form 55002015-10-01408
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01408
2014: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01377
Total number of active participants reported on line 7a of the Form 55002014-10-01392
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01392
2013: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-23297
Total number of active participants reported on line 7a of the Form 55002013-10-23378
Number of retired or separated participants receiving benefits2013-10-230
Number of other retired or separated participants entitled to future benefits2013-10-230
Total of all active and inactive participants2013-10-23378
2012: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-23222
Total number of active participants reported on line 7a of the Form 55002012-10-23297
Number of retired or separated participants receiving benefits2012-10-230
Number of other retired or separated participants entitled to future benefits2012-10-230
Total of all active and inactive participants2012-10-23297
2011: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-23191
Total number of active participants reported on line 7a of the Form 55002011-10-23222
Total of all active and inactive participants2011-10-23222
2010: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-23184
Total number of active participants reported on line 7a of the Form 55002010-10-23191
Total of all active and inactive participants2010-10-23191
2009: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-23207
Total number of active participants reported on line 7a of the Form 55002009-10-23184
Number of retired or separated participants receiving benefits2009-10-239
Number of other retired or separated participants entitled to future benefits2009-10-230
Total of all active and inactive participants2009-10-23193
2008: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-10-23299
Total number of active participants reported on line 7a of the Form 55002008-10-23207
Number of retired or separated participants receiving benefits2008-10-230
Number of other retired or separated participants entitled to future benefits2008-10-230
Total of all active and inactive participants2008-10-23207
2007: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-10-23301
Total number of active participants reported on line 7a of the Form 55002007-10-23299
Number of retired or separated participants receiving benefits2007-10-230
Number of other retired or separated participants entitled to future benefits2007-10-230
Total of all active and inactive participants2007-10-23299
2006: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-10-23309
Total number of active participants reported on line 7a of the Form 55002006-10-23301
Number of retired or separated participants receiving benefits2006-10-230
Number of other retired or separated participants entitled to future benefits2006-10-230
Total of all active and inactive participants2006-10-23301
2005: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-10-23242
Total number of active participants reported on line 7a of the Form 55002005-10-23309
Number of retired or separated participants receiving benefits2005-10-230
Number of other retired or separated participants entitled to future benefits2005-10-230
Total of all active and inactive participants2005-10-23309
2004: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2004 401k membership
Total participants, beginning-of-year2004-10-23207
Total number of active participants reported on line 7a of the Form 55002004-10-23242
Number of retired or separated participants receiving benefits2004-10-230
Number of other retired or separated participants entitled to future benefits2004-10-230
Total of all active and inactive participants2004-10-23242
2003: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2003 401k membership
Total participants, beginning-of-year2003-10-23188
Total number of active participants reported on line 7a of the Form 55002003-10-23207
Number of retired or separated participants receiving benefits2003-10-230
Number of other retired or separated participants entitled to future benefits2003-10-230
Total of all active and inactive participants2003-10-23207
2002: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2002 401k membership
Total participants, beginning-of-year2002-10-23148
Total number of active participants reported on line 7a of the Form 55002002-10-23188
Number of retired or separated participants receiving benefits2002-10-230
Number of other retired or separated participants entitled to future benefits2002-10-230
Total of all active and inactive participants2002-10-23188
2001: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2001 401k membership
Total participants, beginning-of-year2001-10-23160
Total number of active participants reported on line 7a of the Form 55002001-10-23148
Number of retired or separated participants receiving benefits2001-10-230
Number of other retired or separated participants entitled to future benefits2001-10-230
Total of all active and inactive participants2001-10-23148
2000: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2000 401k membership
Total participants, beginning-of-year2000-10-23148
Total number of active participants reported on line 7a of the Form 55002000-10-23160
Number of retired or separated participants receiving benefits2000-10-230
Number of other retired or separated participants entitled to future benefits2000-10-230
Total of all active and inactive participants2000-10-23160
1999: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 1999 401k membership
Total participants, beginning-of-year1999-10-23164
Total number of active participants reported on line 7a of the Form 55001999-10-23148
Number of retired or separated participants receiving benefits1999-10-230
Number of other retired or separated participants entitled to future benefits1999-10-230
Total of all active and inactive participants1999-10-23148
1998: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 1998 401k membership
Total participants, beginning-of-year1998-10-23122
Total number of active participants reported on line 7a of the Form 55001998-10-23164
Number of retired or separated participants receiving benefits1998-10-230
Number of other retired or separated participants entitled to future benefits1998-10-230
Total of all active and inactive participants1998-10-23164
1997: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 1997 401k membership
Total participants, beginning-of-year1997-10-23122
Total number of active participants reported on line 7a of the Form 55001997-10-23122
Number of retired or separated participants receiving benefits1997-10-230
Number of other retired or separated participants entitled to future benefits1997-10-230
Total of all active and inactive participants1997-10-23122

Form 5500 Responses for JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN

2022: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Submission has been amendedNo
2022-10-01This submission is the final filingNo
2022-10-01This return/report is a short plan year return/report (less than 12 months)No
2022-10-01Plan is a collectively bargained planNo
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan funding arrangement – General assets of the sponsorYes
2022-10-01Plan benefit arrangement – InsuranceYes
2022-10-01Plan benefit arrangement – General assets of the sponsorYes
2021: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Submission has been amendedNo
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planNo
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-10-23Type of plan entitySingle employer plan
2013-10-23Submission has been amendedNo
2013-10-23This submission is the final filingNo
2013-10-23This return/report is a short plan year return/report (less than 12 months)Yes
2013-10-23Plan is a collectively bargained planNo
2013-10-23Plan funding arrangement – InsuranceYes
2013-10-23Plan funding arrangement – General assets of the sponsorYes
2013-10-23Plan benefit arrangement – InsuranceYes
2013-10-23Plan benefit arrangement – General assets of the sponsorYes
2012: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-10-23Type of plan entitySingle employer plan
2012-10-23Submission has been amendedNo
2012-10-23This submission is the final filingNo
2012-10-23This return/report is a short plan year return/report (less than 12 months)No
2012-10-23Plan is a collectively bargained planNo
2012-10-23Plan funding arrangement – InsuranceYes
2012-10-23Plan funding arrangement – General assets of the sponsorYes
2012-10-23Plan benefit arrangement – InsuranceYes
2012-10-23Plan benefit arrangement – General assets of the sponsorYes
2011: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-10-23Type of plan entitySingle employer plan
2011-10-23Submission has been amendedNo
2011-10-23This submission is the final filingNo
2011-10-23This return/report is a short plan year return/report (less than 12 months)No
2011-10-23Plan is a collectively bargained planNo
2011-10-23Plan funding arrangement – InsuranceYes
2011-10-23Plan funding arrangement – General assets of the sponsorYes
2011-10-23Plan benefit arrangement – InsuranceYes
2011-10-23Plan benefit arrangement – General assets of the sponsorYes
2010: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-10-23Type of plan entitySingle employer plan
2010-10-23Submission has been amendedNo
2010-10-23This submission is the final filingNo
2010-10-23This return/report is a short plan year return/report (less than 12 months)No
2010-10-23Plan is a collectively bargained planNo
2010-10-23Plan funding arrangement – InsuranceYes
2010-10-23Plan funding arrangement – General assets of the sponsorYes
2010-10-23Plan benefit arrangement – InsuranceYes
2010-10-23Plan benefit arrangement – General assets of the sponsorYes
2009: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-10-23Type of plan entitySingle employer plan
2009-10-23Submission has been amendedNo
2009-10-23This submission is the final filingNo
2009-10-23This return/report is a short plan year return/report (less than 12 months)No
2009-10-23Plan is a collectively bargained planNo
2009-10-23Plan funding arrangement – InsuranceYes
2009-10-23Plan funding arrangement – General assets of the sponsorYes
2009-10-23Plan benefit arrangement – InsuranceYes
2009-10-23Plan benefit arrangement – General assets of the sponsorYes
2008: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2008 form 5500 responses
2008-10-23Type of plan entitySingle employer plan
2008-10-23Submission has been amendedNo
2008-10-23This submission is the final filingNo
2008-10-23This return/report is a short plan year return/report (less than 12 months)No
2008-10-23Plan is a collectively bargained planNo
2008-10-23Plan funding arrangement – InsuranceYes
2008-10-23Plan benefit arrangement – InsuranceYes
2007: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2007 form 5500 responses
2007-10-23Type of plan entitySingle employer plan
2007-10-23Submission has been amendedNo
2007-10-23This submission is the final filingNo
2007-10-23This return/report is a short plan year return/report (less than 12 months)No
2007-10-23Plan is a collectively bargained planNo
2007-10-23Plan funding arrangement – InsuranceYes
2007-10-23Plan benefit arrangement – InsuranceYes
2006: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2006 form 5500 responses
2006-10-23Type of plan entitySingle employer plan
2006-10-23Submission has been amendedNo
2006-10-23This submission is the final filingNo
2006-10-23This return/report is a short plan year return/report (less than 12 months)No
2006-10-23Plan is a collectively bargained planNo
2006-10-23Plan funding arrangement – InsuranceYes
2006-10-23Plan benefit arrangement – InsuranceYes
2005: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2005 form 5500 responses
2005-10-23Type of plan entitySingle employer plan
2005-10-23Submission has been amendedNo
2005-10-23This submission is the final filingNo
2005-10-23This return/report is a short plan year return/report (less than 12 months)No
2005-10-23Plan is a collectively bargained planNo
2005-10-23Plan funding arrangement – InsuranceYes
2005-10-23Plan benefit arrangement – InsuranceYes
2004: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2004 form 5500 responses
2004-10-23Type of plan entitySingle employer plan
2004-10-23Submission has been amendedNo
2004-10-23This submission is the final filingNo
2004-10-23This return/report is a short plan year return/report (less than 12 months)No
2004-10-23Plan is a collectively bargained planNo
2004-10-23Plan funding arrangement – InsuranceYes
2004-10-23Plan benefit arrangement – InsuranceYes
2003: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2003 form 5500 responses
2003-10-23Type of plan entitySingle employer plan
2003-10-23Submission has been amendedNo
2003-10-23This submission is the final filingNo
2003-10-23This return/report is a short plan year return/report (less than 12 months)No
2003-10-23Plan is a collectively bargained planNo
2003-10-23Plan funding arrangement – InsuranceYes
2003-10-23Plan benefit arrangement – InsuranceYes
2002: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2002 form 5500 responses
2002-10-23Type of plan entitySingle employer plan
2002-10-23Submission has been amendedNo
2002-10-23This submission is the final filingNo
2002-10-23This return/report is a short plan year return/report (less than 12 months)No
2002-10-23Plan is a collectively bargained planNo
2002-10-23Plan funding arrangement – InsuranceYes
2002-10-23Plan benefit arrangement – InsuranceYes
2001: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2001 form 5500 responses
2001-10-23Type of plan entitySingle employer plan
2001-10-23Submission has been amendedNo
2001-10-23This submission is the final filingNo
2001-10-23This return/report is a short plan year return/report (less than 12 months)No
2001-10-23Plan is a collectively bargained planNo
2001-10-23Plan funding arrangement – InsuranceYes
2001-10-23Plan benefit arrangement – InsuranceYes
2000: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 2000 form 5500 responses
2000-10-23Type of plan entitySingle employer plan
2000-10-23Submission has been amendedNo
2000-10-23This submission is the final filingNo
2000-10-23This return/report is a short plan year return/report (less than 12 months)No
2000-10-23Plan is a collectively bargained planNo
2000-10-23Plan funding arrangement – InsuranceYes
2000-10-23Plan benefit arrangement – InsuranceYes
1999: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 1999 form 5500 responses
1999-10-23Type of plan entitySingle employer plan
1999-10-23Submission has been amendedNo
1999-10-23This submission is the final filingNo
1999-10-23This return/report is a short plan year return/report (less than 12 months)No
1999-10-23Plan is a collectively bargained planNo
1999-10-23Plan funding arrangement – InsuranceYes
1999-10-23Plan benefit arrangement – InsuranceYes
1998: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 1998 form 5500 responses
1998-10-23Type of plan entitySingle employer plan
1998-10-23Submission has been amendedNo
1998-10-23This submission is the final filingNo
1998-10-23This return/report is a short plan year return/report (less than 12 months)No
1998-10-23Plan is a collectively bargained planNo
1998-10-23Plan funding arrangement – InsuranceYes
1998-10-23Plan benefit arrangement – InsuranceYes
1997: JOHN MORIARTY & ASSOCIATES, INC. WELFARE BENEFIT PLAN 1997 form 5500 responses
1997-10-23Type of plan entitySingle employer plan
1997-10-23First time form 5500 has been submittedYes
1997-10-23Submission has been amendedNo
1997-10-23This submission is the final filingNo
1997-10-23This return/report is a short plan year return/report (less than 12 months)No
1997-10-23Plan is a collectively bargained planNo
1997-10-23Plan funding arrangement – InsuranceYes
1997-10-23Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MONTGOMERY & ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberEAP
Policy instance 4
Insurance contract or identification numberEAP
Number of Individuals Covered0
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE 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 $7,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number60293
Policy instance 3
Insurance contract or identification number60293
Number of Individuals Covered564
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $34,265
Total amount of fees paid to insurance companyUSD $123
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 BenefitNo
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 $234,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,265
Insurance broker organization code?3
Amount paid for insurance broker fees123
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number743017
Policy instance 2
Insurance contract or identification number743017
Number of Individuals Covered1296
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $106,128
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 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 $9,970,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106,128
Insurance broker organization code?3
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number13498
Policy instance 1
Insurance contract or identification number13498
Number of Individuals Covered340
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $13,671
Total amount of fees paid to insurance companyUSD $3,376
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 $364,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,671
Amount paid for insurance broker fees3376
Additional information about fees paid to insurance brokerOTHER FEES
Insurance broker organization code?3
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number13498
Policy instance 1
Insurance contract or identification number13498
Number of Individuals Covered745
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $15,350
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 $308,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,350
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number743017
Policy instance 2
Insurance contract or identification number743017
Number of Individuals Covered1248
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $97,392
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 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 $10,957,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $97,392
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number60293
Policy instance 3
Insurance contract or identification number60293
Number of Individuals Covered569
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $31,140
Total amount of fees paid to insurance companyUSD $87
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 BenefitNo
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 $217,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,835
Insurance broker organization code?3
Amount paid for insurance broker fees87
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION
MONTGOMERY & ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberEAP
Policy instance 4
Insurance contract or identification numberEAP
Number of Individuals Covered0
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE 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 $7,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
MONTGOMERY & ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberEAP
Policy instance 4
Insurance contract or identification numberEAP
Number of Individuals Covered543
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $7,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number60293
Policy instance 3
Insurance contract or identification number60293
Number of Individuals Covered518
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $21,843
Total amount of fees paid to insurance companyUSD $7,877
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $207,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,843
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number743017
Policy instance 2
Insurance contract or identification number743017
Number of Individuals Covered1120
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $86,158
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,438,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $86,172
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number13498
Policy instance 1
Insurance contract or identification number13498
Number of Individuals Covered640
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $12,545
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $278,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,544
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number60293
Policy instance 3
Insurance contract or identification number60293
Number of Individuals Covered535
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $38,202
Total amount of fees paid to insurance companyUSD $136
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 BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $218,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,354
Insurance broker organization code?3
Amount paid for insurance broker fees72
Additional information about fees paid to insurance brokerTPA FEES
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number013498
Policy instance 2
Insurance contract or identification number013498
Number of Individuals Covered629
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $8,077
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 $282,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,932
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0743017
Policy instance 1
Insurance contract or identification number0743017
Number of Individuals Covered1152
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $98,630
Total amount of fees paid to insurance companyUSD $12,215
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 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 $9,960,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,509
Amount paid for insurance broker fees12215
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0743017
Policy instance 1
Insurance contract or identification number0743017
Number of Individuals Covered495
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $104,965
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
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 $9,153,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $104,965
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number013498
Policy instance 2
Insurance contract or identification number013498
Number of Individuals Covered598
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $13,198
Total amount of fees paid to insurance companyUSD $1,375
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 $248,679
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,198
Amount paid for insurance broker fees1375
Additional information about fees paid to insurance brokerCOMMISSIONS AND FEES
Insurance broker organization code?3
MONTGOMERY & ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number000000000000000
Policy instance 3
Insurance contract or identification number000000000000000
Number of Individuals Covered522
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE 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 $7,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number60293
Policy instance 4
Insurance contract or identification number60293
Number of Individuals Covered522
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $29,245
Total amount of fees paid to insurance companyUSD $172
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 BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $2,018,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,245
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number60293
Policy instance 4
Insurance contract or identification number60293
Number of Individuals Covered444
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $18,704
Total amount of fees paid to insurance companyUSD $162
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 BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $176,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONTGOMERY & ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number000000000000000
Policy instance 3
Insurance contract or identification number000000000000000
Number of Individuals Covered0
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE 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 $7,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number013498
Policy instance 2
Insurance contract or identification number013498
Number of Individuals Covered485
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $9,471
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 $203,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0743017
Policy instance 1
Insurance contract or identification number0743017
Number of Individuals Covered407
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $88,886
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
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 $6,605,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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