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PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 401k Plan overview

Plan NamePAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN
Plan identification number 503

PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES has sponsored the creation of one or more 401k plans.

Company Name:PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES
Employer identification number (EIN):150533545
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-01-01
5032022-01-01
5032021-01-01
5032020-01-01
5032019-01-01
5032018-01-01
5032017-01-01SHARON VAN AUKEN SHARON VAN AUKEN2018-07-17
5032016-01-01SHARON VAN AUKEN SHARON VAN AUKEN2017-07-28
5032015-01-01SHARON VAN AUKEN SHARON VAN AUKEN2016-10-13
5032014-01-01SHARON VAN AUKEN SHARON VAN AUKEN2015-10-15
5032013-01-01SHARON VAN AUKEN
5032012-01-01SHARON VAN AUKEN SHARON VAN AUKEN2013-10-12
5032011-01-01LAURA ROZELL
5032010-01-01ANN MARIE SOMMA
5032009-01-01ANN MARIE SOMMA
5032008-01-01ANN MARIE SOMMA
5032007-01-01ANN MARIE SOMMA
5032006-01-01ANN MARIE SOMMA
5032005-01-01ANN MARIE SOMMA
5032004-01-01ANN MARIE SOMMA
5032003-01-01ANN MARIE SOMMA
5032002-01-01ANN MARIE SOMMA
5032001-01-01ANN MARIE SOMMA
5032000-01-01ANN MARIE SOMMA
5031999-01-01ANN MARIE SOMMA
5031998-01-01ANN MARIE SOMMA
5031997-01-01ANN MARIE SOMMA
5031996-01-01ANN MARIE SOMMA

Plan Statistics for PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN

401k plan membership statisitcs for PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN

Measure Date Value
2023: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01136
Total number of active participants reported on line 7a of the Form 55002023-01-01116
Total of all active and inactive participants2023-01-01116
2022: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01110
Total number of active participants reported on line 7a of the Form 55002022-01-01197
Total of all active and inactive participants2022-01-01197
2021: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01112
Total number of active participants reported on line 7a of the Form 55002021-01-01110
Total of all active and inactive participants2021-01-01110
2020: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01108
Total number of active participants reported on line 7a of the Form 55002020-01-01112
Total of all active and inactive participants2020-01-01112
2019: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01117
Total number of active participants reported on line 7a of the Form 55002019-01-01108
Total of all active and inactive participants2019-01-01108
2018: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01121
Total number of active participants reported on line 7a of the Form 55002018-01-01117
Total of all active and inactive participants2018-01-01117
2017: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01118
Total number of active participants reported on line 7a of the Form 55002017-01-01121
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 participants2017-01-01121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01121
2016: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01117
Total number of active participants reported on line 7a of the Form 55002016-01-01118
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01118
Total participants2016-01-01118
2015: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01108
Total number of active participants reported on line 7a of the Form 55002015-01-01117
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01117
Total participants2015-01-01117
2014: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01116
Total number of active participants reported on line 7a of the Form 55002014-01-01108
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01108
Total participants2014-01-01108
2013: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01123
Total number of active participants reported on line 7a of the Form 55002013-01-01116
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01116
Total participants2013-01-01116
2012: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01125
Total number of active participants reported on line 7a of the Form 55002012-01-01123
Total of all active and inactive participants2012-01-01123
Total participants2012-01-01123
2011: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01116
Total number of active participants reported on line 7a of the Form 55002011-01-01125
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01125
2010: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01114
Total number of active participants reported on line 7a of the Form 55002010-01-01116
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01116
Total participants2010-01-01116
2009: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01118
Total number of active participants reported on line 7a of the Form 55002009-01-01114
Total of all active and inactive participants2009-01-01114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01114
2008: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01122
Total number of active participants reported on line 7a of the Form 55002008-01-01118
Total of all active and inactive participants2008-01-01118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-01-010
Total participants2008-01-01118
2007: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01144
Total number of active participants reported on line 7a of the Form 55002007-01-01122
Total of all active and inactive participants2007-01-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2007-01-010
Total participants2007-01-01122
2006: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01153
Total number of active participants reported on line 7a of the Form 55002006-01-01144
Total of all active and inactive participants2006-01-01144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2006-01-010
Total participants2006-01-01144
2005: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01100
Total number of active participants reported on line 7a of the Form 55002005-01-01153
Total of all active and inactive participants2005-01-01153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2005-01-010
Total participants2005-01-01153
2004: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01100
Total number of active participants reported on line 7a of the Form 55002004-01-01100
Total of all active and inactive participants2004-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2004-01-010
Total participants2004-01-01100
2003: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01100
Total number of active participants reported on line 7a of the Form 55002003-01-01100
Total of all active and inactive participants2003-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2003-01-010
Total participants2003-01-01100
2002: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-01100
Total number of active participants reported on line 7a of the Form 55002002-01-01100
Total of all active and inactive participants2002-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2002-01-010
Total participants2002-01-01100
2001: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2001 401k membership
Total participants, beginning-of-year2001-01-01100
Total number of active participants reported on line 7a of the Form 55002001-01-01100
Total of all active and inactive participants2001-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2001-01-010
Total participants2001-01-01100
2000: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2000 401k membership
Total participants, beginning-of-year2000-01-01100
Total number of active participants reported on line 7a of the Form 55002000-01-01100
Total of all active and inactive participants2000-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2000-01-010
Total participants2000-01-01100
1999: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 1999 401k membership
Total participants, beginning-of-year1999-01-01100
Total number of active participants reported on line 7a of the Form 55001999-01-01100
Total of all active and inactive participants1999-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits1999-01-010
Total participants1999-01-01100
1998: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 1998 401k membership
Total participants, beginning-of-year1998-01-01100
Total number of active participants reported on line 7a of the Form 55001998-01-01100
Total of all active and inactive participants1998-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits1998-01-010
Total participants1998-01-01100
1997: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 1997 401k membership
Total participants, beginning-of-year1997-01-01100
Total number of active participants reported on line 7a of the Form 55001997-01-01100
Total of all active and inactive participants1997-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits1997-01-010
Total participants1997-01-01100
1996: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 1996 401k membership
Total participants, beginning-of-year1996-01-01100
Total number of active participants reported on line 7a of the Form 55001996-01-01100
Total of all active and inactive participants1996-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits1996-01-010
Total participants1996-01-01100

Form 5500 Responses for PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN

2023: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2019 form 5500 responses
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: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2018 form 5500 responses
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: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2017 form 5500 responses
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 benefit arrangement – InsuranceYes
2016: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes
2006: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – InsuranceYes
2005: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedNo
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – InsuranceYes
2004: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedNo
2004-01-01This submission is the final filingNo
2004-01-01This return/report is a short plan year return/report (less than 12 months)No
2004-01-01Plan is a collectively bargained planNo
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – InsuranceYes
2003: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2003 form 5500 responses
2003-01-01Type of plan entitySingle employer plan
2003-01-01Submission has been amendedNo
2003-01-01This submission is the final filingNo
2003-01-01This return/report is a short plan year return/report (less than 12 months)No
2003-01-01Plan is a collectively bargained planNo
2003-01-01Plan funding arrangement – InsuranceYes
2003-01-01Plan benefit arrangement – InsuranceYes
2002: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2002 form 5500 responses
2002-01-01Type of plan entitySingle employer plan
2002-01-01Submission has been amendedNo
2002-01-01This submission is the final filingNo
2002-01-01This return/report is a short plan year return/report (less than 12 months)No
2002-01-01Plan is a collectively bargained planNo
2002-01-01Plan funding arrangement – InsuranceYes
2002-01-01Plan benefit arrangement – InsuranceYes
2001: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2001 form 5500 responses
2001-01-01Type of plan entitySingle employer plan
2001-01-01Submission has been amendedNo
2001-01-01This submission is the final filingNo
2001-01-01This return/report is a short plan year return/report (less than 12 months)No
2001-01-01Plan is a collectively bargained planNo
2001-01-01Plan funding arrangement – InsuranceYes
2001-01-01Plan benefit arrangement – InsuranceYes
2000: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 2000 form 5500 responses
2000-01-01Type of plan entitySingle employer plan
2000-01-01Submission has been amendedNo
2000-01-01This submission is the final filingNo
2000-01-01This return/report is a short plan year return/report (less than 12 months)No
2000-01-01Plan is a collectively bargained planNo
2000-01-01Plan funding arrangement – InsuranceYes
2000-01-01Plan benefit arrangement – InsuranceYes
1999: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 1999 form 5500 responses
1999-01-01Type of plan entitySingle employer plan
1999-01-01Submission has been amendedNo
1999-01-01This submission is the final filingNo
1999-01-01This return/report is a short plan year return/report (less than 12 months)No
1999-01-01Plan is a collectively bargained planNo
1999-01-01Plan funding arrangement – InsuranceYes
1999-01-01Plan benefit arrangement – InsuranceYes
1998: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 1998 form 5500 responses
1998-01-01Type of plan entitySingle employer plan
1998-01-01Submission has been amendedNo
1998-01-01This submission is the final filingNo
1998-01-01This return/report is a short plan year return/report (less than 12 months)No
1998-01-01Plan is a collectively bargained planNo
1998-01-01Plan funding arrangement – InsuranceYes
1998-01-01Plan benefit arrangement – InsuranceYes
1997: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 1997 form 5500 responses
1997-01-01Type of plan entitySingle employer plan
1997-01-01Submission has been amendedNo
1997-01-01This submission is the final filingNo
1997-01-01This return/report is a short plan year return/report (less than 12 months)No
1997-01-01Plan is a collectively bargained planNo
1997-01-01Plan funding arrangement – InsuranceYes
1997-01-01Plan benefit arrangement – InsuranceYes
1996: PAUL SMITH'S COLLEGE OF ARTS AND SCIENCES EMPLOYEE CHOICE PLAN 1996 form 5500 responses
1996-01-01Type of plan entitySingle employer plan
1996-01-01Submission has been amendedNo
1996-01-01This submission is the final filingNo
1996-01-01This return/report is a short plan year return/report (less than 12 months)No
1996-01-01Plan is a collectively bargained planNo
1996-01-01Plan funding arrangement – InsuranceYes
1996-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 )
Policy contract number490654
Policy instance 3
Insurance contract or identification number490654
Number of Individuals Covered185
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $40,573
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 $803,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481745
Policy instance 2
Insurance contract or identification number00481745
Number of Individuals Covered90
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,229
Total amount of fees paid to insurance companyUSD $2,260
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 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 $78,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberR0797175
Policy instance 1
Insurance contract or identification numberR0797175
Number of Individuals Covered34
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $857
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, SPECIFIED DISEASE
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 $5,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 )
Policy contract number490654
Policy instance 2
Insurance contract or identification number490654
Number of Individuals Covered197
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $32,905
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 $749,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,905
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481745
Policy instance 1
Insurance contract or identification number00481745
Number of Individuals Covered97
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,883
Total amount of fees paid to insurance companyUSD $2,389
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 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 $64,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,883
Amount paid for insurance broker fees2389
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00036286
Policy instance 2
Insurance contract or identification number00036286
Number of Individuals Covered110
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $37,603
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,603
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481745
Policy instance 1
Insurance contract or identification number00481745
Number of Individuals Covered90
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,017
Total amount of fees paid to insurance companyUSD $2,226
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 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 $68,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,949
Amount paid for insurance broker fees2226
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00036286
Policy instance 2
Insurance contract or identification number00036286
Number of Individuals Covered112
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $32,573
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,573
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481745
Policy instance 1
Insurance contract or identification number00481745
Number of Individuals Covered93
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,249
Total amount of fees paid to insurance companyUSD $4,457
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 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 $57,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,185
Amount paid for insurance broker fees4457
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00036286
Policy instance 2
Insurance contract or identification number00036286
Number of Individuals Covered108
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $38,801
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,801
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481745
Policy instance 1
Insurance contract or identification number00481745
Number of Individuals Covered88
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,803
Total amount of fees paid to insurance companyUSD $4,172
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 BenefitYes
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 $67,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,793
Amount paid for insurance broker fees4172
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00036286
Policy instance 2
Insurance contract or identification number00036286
Number of Individuals Covered117
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $41,033
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,033
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481745
Policy instance 1
Insurance contract or identification number00481745
Number of Individuals Covered101
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,483
Total amount of fees paid to insurance companyUSD $1,360
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 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 $74,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,351
Amount paid for insurance broker fees1360
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00036286
Policy instance 1
Insurance contract or identification number00036286
Number of Individuals Covered121
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $45,071
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,291
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBURNHAM FINANCIAL SERVICES, LLC

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