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UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN 401k Plan overview

Plan NameUNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN
Plan identification number 501

UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES has sponsored the creation of one or more 401k plans.

Company Name:UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES
Employer identification number (EIN):593166042
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012013-01-01WANDA NITSCH WANDA NITSCH2014-09-30
5012012-01-01RACHELLE AGATHA RACHELLE AGATHA2013-06-20
5012011-01-01RACHELLE AGATHA

Plan Statistics for UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN

401k plan membership statisitcs for UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN

Measure Date Value
2013: UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01147
Total number of active participants reported on line 7a of the Form 55002013-01-01163
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 participants2013-01-01163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01163
Number of employers contributing to the scheme2013-01-01163
2012: UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01147
Total number of active participants reported on line 7a of the Form 55002012-01-01147
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 participants2012-01-01147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01147
Number of employers contributing to the scheme2012-01-01147
2011: UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01117
Total number of active participants reported on line 7a of the Form 55002011-01-01117
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 participants2011-01-01117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01117
Number of employers contributing to the scheme2011-01-01117

Form 5500 Responses for UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN

2013: UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT 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 filingYes
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: UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
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: UNIVERSITY OF ST. AUGUSTINE FOR HEALTH SCIENCES WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109790
Policy instance 6
Insurance contract or identification number000010109790
Number of Individuals Covered66
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,077
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $21,935
Commission paid to Insurance BrokerUSD $3,290
Amount paid for insurance broker fees787
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109789
Policy instance 5
Insurance contract or identification number000010109789
Number of Individuals Covered73
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,137
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $23,049
Commission paid to Insurance BrokerUSD $3,457
Amount paid for insurance broker fees680
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109788
Policy instance 4
Insurance contract or identification number000010109788
Number of Individuals Covered163
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,926
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $10,531
Commission paid to Insurance BrokerUSD $1,580
Amount paid for insurance broker fees346
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number632390
Policy instance 3
Insurance contract or identification number632390
Number of Individuals Covered126
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $14,887
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare 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 $88,756
Commission paid to Insurance BrokerUSD $13,313
Amount paid for insurance broker fees1574
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract numberB3758
Policy instance 2
Insurance contract or identification numberB3758
Number of Individuals Covered7
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,525
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
Commission paid to Insurance BrokerUSD $3,525
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberB3758
Policy instance 1
Insurance contract or identification numberB3758
Number of Individuals Covered154
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $56,976
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
Commission paid to Insurance BrokerUSD $56,976
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number202751/467881
Policy instance 1
Insurance contract or identification number202751/467881
Number of Individuals Covered213
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $38,603
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $956,745
Commission paid to Insurance BrokerUSD $43,146
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameHAROLD GLYNN HOLTON
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109789
Policy instance 9
Insurance contract or identification number000010109789
Number of Individuals Covered65
Insurance policy start date2012-12-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $237
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,582
Commission paid to Insurance BrokerUSD $237
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109789
Policy instance 8
Insurance contract or identification number000010109789
Number of Individuals Covered65
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $3,492
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,991
Commission paid to Insurance BrokerUSD $2,623
Amount paid for insurance broker fees869
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109790
Policy instance 7
Insurance contract or identification number000010109790
Number of Individuals Covered64
Insurance policy start date2012-12-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $265
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,768
Commission paid to Insurance BrokerUSD $265
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109790
Policy instance 6
Insurance contract or identification number000010109790
Number of Individuals Covered63
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $4,071
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,975
Commission paid to Insurance BrokerUSD $3,053
Amount paid for insurance broker fees1018
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400001000
Policy instance 5
Insurance contract or identification number000400001000
Number of Individuals Covered56
Insurance policy start date2012-12-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $309
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,545
Commission paid to Insurance BrokerUSD $309
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number0000400001000
Policy instance 4
Insurance contract or identification number0000400001000
Number of Individuals Covered54
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $3,825
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,201
Commission paid to Insurance BrokerUSD $3,173
Amount paid for insurance broker fees625
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109788
Policy instance 3
Insurance contract or identification number000010109788
Number of Individuals Covered147
Insurance policy start date2012-12-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $123
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $818
Commission paid to Insurance BrokerUSD $123
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109788
Policy instance 2
Insurance contract or identification number000010109788
Number of Individuals Covered146
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $1,713
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,106
Commission paid to Insurance BrokerUSD $1,329
Amount paid for insurance broker fees384
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010109788
Policy instance 1
Insurance contract or identification number000010109788
Number of Individuals Covered117
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $754
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,538
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number467881
Policy instance 2
Insurance contract or identification number467881
Number of Individuals Covered152
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $48,949
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $966,504

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