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HEALTH INSURANCE PLAN 401k Plan overview

Plan NameHEALTH INSURANCE PLAN
Plan identification number 501

HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

THE YORK WATER COMPANY has sponsored the creation of one or more 401k plans.

Company Name:THE YORK WATER COMPANY
Employer identification number (EIN):231242500
NAIC Classification:221300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01NATALEE COLON MATTHEW E. POFF2019-07-16
5012017-01-01NATALEE COLON MATTHEW E. POFF2018-07-31
5012016-01-01NATALEE COLON KATHLEEN MILLER2017-07-14
5012015-01-01BRUCE C. MCINTOSH KATHLEEN MILLER2016-06-15
5012014-01-01BRUCE C. MCINTOSH KATHLEEN MILLER2015-10-07
5012013-01-01BRUCE C. MCINTOSH KATHLEEN MILLER2014-10-09
5012012-01-01BRUCE C. MCINTOSH KATHLEEN MILLER2013-06-20
5012011-01-01BRUCE C. MCINTOSH KATHLEEN MILLER2012-04-17
5012010-01-01BRUCE C. MCINTOSH KATHLEEN MILLER2011-04-29
5012009-01-01BRUCE MCINTOSH KATHLEEN MILLER2010-06-02

Plan Statistics for HEALTH INSURANCE PLAN

401k plan membership statisitcs for HEALTH INSURANCE PLAN

Measure Date Value
2023: HEALTH INSURANCE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-0197
Total number of active participants reported on line 7a of the Form 55002023-01-01105
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01105
2022: HEALTH INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0194
Total number of active participants reported on line 7a of the Form 55002022-01-0190
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0190
2021: HEALTH INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0193
Total number of active participants reported on line 7a of the Form 55002021-01-0189
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0189
2020: HEALTH INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0188
Total number of active participants reported on line 7a of the Form 55002020-01-0187
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0190
2019: HEALTH INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0194
Total number of active participants reported on line 7a of the Form 55002019-01-0186
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0188
2018: HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0190
Total number of active participants reported on line 7a of the Form 55002018-01-0191
Number of retired or separated participants receiving benefits2018-01-013
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0194
2017: HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0189
Total number of active participants reported on line 7a of the Form 55002017-01-0186
Number of retired or separated participants receiving benefits2017-01-012
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0188
2016: HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0191
Total number of active participants reported on line 7a of the Form 55002016-01-0187
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0190
2015: HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0190
Total number of active participants reported on line 7a of the Form 55002015-01-0191
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 participants2015-01-0191
2014: HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0187
Total number of active participants reported on line 7a of the Form 55002014-01-0191
Number of retired or separated participants receiving benefits2014-01-013
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0194
2013: HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0187
Total number of active participants reported on line 7a of the Form 55002013-01-0186
Number of retired or separated participants receiving benefits2013-01-012
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0188
2012: HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01106
Total number of active participants reported on line 7a of the Form 55002012-01-01103
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01103
2011: HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0196
Total number of active participants reported on line 7a of the Form 55002011-01-01106
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 participants2011-01-01106
2010: HEALTH INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0199
Total number of active participants reported on line 7a of the Form 55002010-01-0196
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 participants2010-01-0196
2009: HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01103
Total number of active participants reported on line 7a of the Form 55002009-01-0198
Number of retired or separated participants receiving benefits2009-01-011
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-0199

Financial Data on HEALTH INSURANCE PLAN

Measure Date Value
2022 : HEALTH INSURANCE PLAN 2022 401k financial data
Total income from all sources2022-12-31$1,328,144
Expenses. Total of all expenses incurred2022-12-31$1,343,305
Benefits paid (including direct rollovers)2022-12-31$891,382
Total plan assets at end of year2022-12-31$467,582
Total plan assets at beginning of year2022-12-31$482,743
Value of fidelity bond covering the plan2022-12-31$1,750,000
Total contributions received or receivable from participants2022-12-31$283,384
Expenses. Other expenses not covered elsewhere2022-12-31$392,806
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$7,106
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-15,161
Net plan assets at end of year (total assets less liabilities)2022-12-31$467,582
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$482,743
Total contributions received or receivable from employer(s)2022-12-31$1,037,654
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$59,117
2021 : HEALTH INSURANCE PLAN 2021 401k financial data
Total income from all sources2021-12-31$885,589
Expenses. Total of all expenses incurred2021-12-31$1,471,730
Benefits paid (including direct rollovers)2021-12-31$1,068,927
Total plan assets at end of year2021-12-31$482,743
Total plan assets at beginning of year2021-12-31$1,068,884
Value of fidelity bond covering the plan2021-12-31$1,750,000
Total contributions received or receivable from participants2021-12-31$302,595
Expenses. Other expenses not covered elsewhere2021-12-31$352,021
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$86
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$-586,141
Net plan assets at end of year (total assets less liabilities)2021-12-31$482,743
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,068,884
Total contributions received or receivable from employer(s)2021-12-31$582,908
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$50,782
2020 : HEALTH INSURANCE PLAN 2020 401k financial data
Total income from all sources2020-12-31$1,507,845
Expenses. Total of all expenses incurred2020-12-31$923,578
Benefits paid (including direct rollovers)2020-12-31$540,658
Total plan assets at end of year2020-12-31$1,068,884
Total plan assets at beginning of year2020-12-31$484,617
Value of fidelity bond covering the plan2020-12-31$1,750,000
Total contributions received or receivable from participants2020-12-31$283,309
Expenses. Other expenses not covered elsewhere2020-12-31$303,033
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$1,899
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$584,267
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,068,884
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$484,617
Total contributions received or receivable from employer(s)2020-12-31$1,222,637
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$79,887
2019 : HEALTH INSURANCE PLAN 2019 401k financial data
Total income from all sources2019-12-31$1,434,538
Expenses. Total of all expenses incurred2019-12-31$1,406,826
Benefits paid (including direct rollovers)2019-12-31$1,037,391
Total plan assets at end of year2019-12-31$484,617
Total plan assets at beginning of year2019-12-31$456,905
Value of fidelity bond covering the plan2019-12-31$1,750,000
Total contributions received or receivable from participants2019-12-31$309,215
Expenses. Other expenses not covered elsewhere2019-12-31$280,938
Other income received2019-12-31$14,277
Net income (gross income less expenses)2019-12-31$27,712
Net plan assets at end of year (total assets less liabilities)2019-12-31$484,617
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$456,905
Total contributions received or receivable from employer(s)2019-12-31$1,111,046
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$88,497
2018 : HEALTH INSURANCE PLAN 2018 401k financial data
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$1,457,097
Expenses. Total of all expenses incurred2018-12-31$1,153,849
Benefits paid (including direct rollovers)2018-12-31$821,407
Total plan assets at end of year2018-12-31$456,905
Total plan assets at beginning of year2018-12-31$153,657
Value of fidelity bond covering the plan2018-12-31$1,750,000
Total contributions received or receivable from participants2018-12-31$286,427
Expenses. Other expenses not covered elsewhere2018-12-31$243,231
Other income received2018-12-31$6,220
Net income (gross income less expenses)2018-12-31$303,248
Net plan assets at end of year (total assets less liabilities)2018-12-31$456,905
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$153,657
Total contributions received or receivable from employer(s)2018-12-31$1,164,450
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$89,211
2017 : HEALTH INSURANCE PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$1,385,297
Expenses. Total of all expenses incurred2017-12-31$1,398,714
Benefits paid (including direct rollovers)2017-12-31$1,089,830
Total plan assets at end of year2017-12-31$153,657
Total plan assets at beginning of year2017-12-31$167,074
Value of fidelity bond covering the plan2017-12-31$2,500,000
Total contributions received or receivable from participants2017-12-31$234,249
Expenses. Other expenses not covered elsewhere2017-12-31$224,404
Other income received2017-12-31$1,434
Net income (gross income less expenses)2017-12-31$-13,417
Net plan assets at end of year (total assets less liabilities)2017-12-31$153,657
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$167,074
Total contributions received or receivable from employer(s)2017-12-31$1,149,614
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$84,480
2016 : HEALTH INSURANCE PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$1,178,240
Expenses. Total of all expenses incurred2016-12-31$1,276,379
Benefits paid (including direct rollovers)2016-12-31$990,450
Total plan assets at end of year2016-12-31$167,074
Total plan assets at beginning of year2016-12-31$265,213
Value of fidelity bond covering the plan2016-12-31$3,600,000
Total contributions received or receivable from participants2016-12-31$230,901
Expenses. Other expenses not covered elsewhere2016-12-31$203,370
Other income received2016-12-31$377
Net income (gross income less expenses)2016-12-31$-98,139
Net plan assets at end of year (total assets less liabilities)2016-12-31$167,074
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$265,213
Total contributions received or receivable from employer(s)2016-12-31$946,962
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$82,559
2015 : HEALTH INSURANCE PLAN 2015 401k financial data
Total income from all sources2015-12-31$1,168,908
Expenses. Total of all expenses incurred2015-12-31$991,862
Benefits paid (including direct rollovers)2015-12-31$737,226
Total plan assets at end of year2015-12-31$265,213
Total plan assets at beginning of year2015-12-31$88,167
Value of fidelity bond covering the plan2015-12-31$3,530,000
Total contributions received or receivable from participants2015-12-31$164,638
Expenses. Other expenses not covered elsewhere2015-12-31$179,711
Other income received2015-12-31$47
Net income (gross income less expenses)2015-12-31$177,046
Net plan assets at end of year (total assets less liabilities)2015-12-31$265,213
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$88,167
Total contributions received or receivable from employer(s)2015-12-31$1,004,223
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$74,925
2014 : HEALTH INSURANCE PLAN 2014 401k financial data
Total income from all sources2014-12-31$1,074,134
Expenses. Total of all expenses incurred2014-12-31$1,073,458
Benefits paid (including direct rollovers)2014-12-31$997,090
Total plan assets at end of year2014-12-31$88,167
Total plan assets at beginning of year2014-12-31$87,491
Value of fidelity bond covering the plan2014-12-31$2,500,000
Total contributions received or receivable from participants2014-12-31$93,929
Other income received2014-12-31$12
Net income (gross income less expenses)2014-12-31$676
Net plan assets at end of year (total assets less liabilities)2014-12-31$88,167
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$87,491
Total contributions received or receivable from employer(s)2014-12-31$980,193
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$76,368
2013 : HEALTH INSURANCE PLAN 2013 401k financial data
Total income from all sources2013-12-31$1,373,893
Expenses. Total of all expenses incurred2013-12-31$1,330,692
Benefits paid (including direct rollovers)2013-12-31$1,254,898
Total plan assets at end of year2013-12-31$87,491
Total plan assets at beginning of year2013-12-31$44,290
Value of fidelity bond covering the plan2013-12-31$3,500,000
Total contributions received or receivable from participants2013-12-31$83,791
Other income received2013-12-31$8
Net income (gross income less expenses)2013-12-31$43,201
Net plan assets at end of year (total assets less liabilities)2013-12-31$87,491
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$44,290
Total contributions received or receivable from employer(s)2013-12-31$1,290,094
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$75,794

Form 5500 Responses for HEALTH INSURANCE PLAN

2023: HEALTH INSURANCE 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 planYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement - TrustYes
2022: HEALTH INSURANCE 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 planYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: HEALTH INSURANCE 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 planYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: HEALTH INSURANCE 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 planYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: HEALTH INSURANCE 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 planYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: HEALTH INSURANCE 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 planYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HEALTH INSURANCE 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 planYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: HEALTH INSURANCE 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 planYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: HEALTH INSURANCE 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 planYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: HEALTH INSURANCE 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 planYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: HEALTH INSURANCE 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 planYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: HEALTH INSURANCE 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 planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: HEALTH INSURANCE 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 planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: HEALTH INSURANCE 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 planYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: HEALTH INSURANCE 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 planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number1803280000
Policy instance 1
Insurance contract or identification number1803280000
Number of Individuals Covered232
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $16,493
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $659,711
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,493
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameMCCONKEY BENEFITS & FINANCIAL SVS
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number1803280000
Policy instance 1
Insurance contract or identification number1803280000
Number of Individuals Covered242
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $22,417
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $896,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number1803280000
Policy instance 1
Insurance contract or identification number1803280000
Number of Individuals Covered236
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $19,507
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $708,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,507
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNON-PREMIUM BASED FEES
Insurance broker organization code?3
Insurance broker nameBENECON-MCCONKEY BENEFITS AND FINAN

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