401k Plan data: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN plan

COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN
Plan identification number	510

COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

COMMUNITIES IN SCHOOLS OF HOSTON INC has sponsored the creation of one or more 401k plans.

Company Name: COMMUNITIES IN SCHOOLS OF HOSTON INC

Employer identification number (EIN): 760031827

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Additional information about COMMUNITIES IN SCHOOLS OF HOSTON INC

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1982-08-02

Company Identification Number: 0061715901

Legal Registered Office Address: 1235 NORTH LOOP W STE 300

HOUSTON
United States of America (USA)
77008

More information about COMMUNITIES IN SCHOOLS OF HOSTON INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2023-03-01 MATT GARCIA-PRATS 2024-09-13
510 2022-03-01 JANET CHUNG 2023-12-03
510 2021-03-01 JANET CHUNG 2022-12-07
510 2021-03-01 JANET CHUNG 2024-02-15
510 2020-03-01 JANET CHUNG 2021-08-26
510 2020-03-01 JANET CHUNG 2024-02-15
510 2019-03-01 JOSEPH KEITH LABRIE 2020-09-25
510 2019-03-01 JANET CHUNG 2024-02-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
510	2023-03-01	MATT GARCIA-PRATS	2024-09-13
510	2022-03-01	JANET CHUNG	2023-12-03
510	2021-03-01	JANET CHUNG	2022-12-07
510	2021-03-01	JANET CHUNG	2024-02-15
510	2020-03-01	JANET CHUNG	2021-08-26
510	2020-03-01	JANET CHUNG	2024-02-15
510	2019-03-01	JOSEPH KEITH LABRIE	2020-09-25
510	2019-03-01	JANET CHUNG	2024-02-15

Plan Statistics for COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2023: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year 2023-03-01 120
Total number of active participants reported on line 7a of the Form 5500 2023-03-01 209
Number of retired or separated participants receiving benefits 2023-03-01 0
Number of other retired or separated participants entitled to future benefits 2023-03-01 0
Total of all active and inactive participants 2023-03-01 209
Number of employers contributing to the scheme 2023-03-01 0
2022: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-03-01 111
Total number of active participants reported on line 7a of the Form 5500 2022-03-01 120
Number of retired or separated participants receiving benefits 2022-03-01 0
Number of other retired or separated participants entitled to future benefits 2022-03-01 0
Total of all active and inactive participants 2022-03-01 120
Number of employers contributing to the scheme 2022-03-01 0
2021: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-03-01 149
Total number of active participants reported on line 7a of the Form 5500 2021-03-01 111
Number of retired or separated participants receiving benefits 2021-03-01 0
Number of other retired or separated participants entitled to future benefits 2021-03-01 0
Total of all active and inactive participants 2021-03-01 111
Number of employers contributing to the scheme 2021-03-01 0
2020: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-03-01 210
Total number of active participants reported on line 7a of the Form 5500 2020-03-01 149
Number of retired or separated participants receiving benefits 2020-03-01 0
Number of other retired or separated participants entitled to future benefits 2020-03-01 0
Total of all active and inactive participants 2020-03-01 149
Number of employers contributing to the scheme 2020-03-01 0
2019: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-03-01 184
Total number of active participants reported on line 7a of the Form 5500 2019-03-01 210
Number of retired or separated participants receiving benefits 2019-03-01 0
Number of other retired or separated participants entitled to future benefits 2019-03-01 0
Total of all active and inactive participants 2019-03-01 210
Number of employers contributing to the scheme 2019-03-01 0

Measure	Date	Value
2023: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year	2023-03-01	120
Total number of active participants reported on line 7a of the Form 5500	2023-03-01	209
Number of retired or separated participants receiving benefits	2023-03-01	0
Number of other retired or separated participants entitled to future benefits	2023-03-01	0
Total of all active and inactive participants	2023-03-01	209
Number of employers contributing to the scheme	2023-03-01	0
2022: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-03-01	111
Total number of active participants reported on line 7a of the Form 5500	2022-03-01	120
Number of retired or separated participants receiving benefits	2022-03-01	0
Number of other retired or separated participants entitled to future benefits	2022-03-01	0
Total of all active and inactive participants	2022-03-01	120
Number of employers contributing to the scheme	2022-03-01	0
2021: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-03-01	149
Total number of active participants reported on line 7a of the Form 5500	2021-03-01	111
Number of retired or separated participants receiving benefits	2021-03-01	0
Number of other retired or separated participants entitled to future benefits	2021-03-01	0
Total of all active and inactive participants	2021-03-01	111
Number of employers contributing to the scheme	2021-03-01	0
2020: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-03-01	210
Total number of active participants reported on line 7a of the Form 5500	2020-03-01	149
Number of retired or separated participants receiving benefits	2020-03-01	0
Number of other retired or separated participants entitled to future benefits	2020-03-01	0
Total of all active and inactive participants	2020-03-01	149
Number of employers contributing to the scheme	2020-03-01	0
2019: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-03-01	184
Total number of active participants reported on line 7a of the Form 5500	2019-03-01	210
Number of retired or separated participants receiving benefits	2019-03-01	0
Number of other retired or separated participants entitled to future benefits	2019-03-01	0
Total of all active and inactive participants	2019-03-01	210
Number of employers contributing to the scheme	2019-03-01	0

Form 5500 Responses for COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN

2023: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-03-01	Type of plan entity	Single employer plan
2023-03-01	Plan funding arrangement – Insurance	Yes
2023-03-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-03-01	Plan benefit arrangement – Insurance	Yes
2023-03-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-03-01	Type of plan entity	Single employer plan
2022-03-01	Plan funding arrangement – Insurance	Yes
2022-03-01	Plan benefit arrangement – Insurance	Yes
2021: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-03-01	Type of plan entity	Single employer plan
2021-03-01	Submission has been amended	Yes
2021-03-01	Plan funding arrangement – Insurance	Yes
2021-03-01	Plan benefit arrangement – Insurance	Yes
2020: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-03-01	Type of plan entity	Single employer plan
2020-03-01	Submission has been amended	Yes
2020-03-01	Plan funding arrangement – Insurance	Yes
2020-03-01	Plan benefit arrangement – Insurance	Yes
2019: COMMUNITIES IN SCHOOLS OF HOUSTON, INC. HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-03-01	Type of plan entity	Single employer plan
2019-03-01	First time form 5500 has been submitted	Yes
2019-03-01	Submission has been amended	Yes
2019-03-01	Plan funding arrangement – Insurance	Yes
2019-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM0612608

Policy instance

Insurance contract or identification number	SGM0612608
Number of Individuals Covered	209
Insurance policy start date	2023-03-01
Insurance policy end date	2024-02-29
Total amount of commissions paid to insurance broker	USD $24,075
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $174,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

214674

Policy instance

Insurance contract or identification number	214674
Number of Individuals Covered	165
Insurance policy start date	2023-03-01
Insurance policy end date	2024-02-29
Total amount of commissions paid to insurance broker	USD $10,574
Total amount of fees paid to insurance company	USD $3,038
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $43,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

638775

Policy instance

Insurance contract or identification number	638775
Number of Individuals Covered	209
Insurance policy start date	2023-03-01
Insurance policy end date	2024-02-29
Total amount of commissions paid to insurance broker	USD $10,151
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $102,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 52411 )

Policy contract number

419735

Policy instance

Insurance contract or identification number	419735
Number of Individuals Covered	250
Insurance policy start date	2023-03-01
Insurance policy end date	2024-02-29
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	TELEHEALTH
Welfare Benefit Premiums Paid to Carrier	USD $12,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	365
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $48,863
Total amount of fees paid to insurance company	USD $16,357
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $248,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,191
Amount paid for insurance broker fees	267
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	119
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $2,310
Total amount of fees paid to insurance company	USD $1,000
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,540
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

917228

Policy instance

Insurance contract or identification number	917228
Number of Individuals Covered	282
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $2,141
Total amount of fees paid to insurance company	USD $89,288
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,708,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,141
Amount paid for insurance broker fees	88738
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	280
Insurance policy start date	2021-03-01
Insurance policy end date	2022-02-28
Total amount of commissions paid to insurance broker	USD $37,924
Total amount of fees paid to insurance company	USD $13,127
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $220,978
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,983
Amount paid for insurance broker fees	57
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	102
Insurance policy start date	2021-03-01
Insurance policy end date	2022-02-28
Total amount of commissions paid to insurance broker	USD $2,696
Total amount of fees paid to insurance company	USD $1,148
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,797
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

917228

Policy instance

Insurance contract or identification number	917228
Number of Individuals Covered	262
Insurance policy start date	2021-03-01
Insurance policy end date	2022-02-28
Total amount of commissions paid to insurance broker	USD $1,845
Total amount of fees paid to insurance company	USD $82,312
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,576,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,845
Amount paid for insurance broker fees	81956
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	280
Insurance policy start date	2021-03-01
Insurance policy end date	2022-02-28
Total amount of commissions paid to insurance broker	USD $46,807
Total amount of fees paid to insurance company	USD $15,273
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $258,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,103
Amount paid for insurance broker fees	171
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	102
Insurance policy start date	2021-03-01
Insurance policy end date	2022-02-28
Total amount of commissions paid to insurance broker	USD $2,696
Total amount of fees paid to insurance company	USD $1,148
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,797
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

917228

Policy instance

Insurance contract or identification number	917228
Number of Individuals Covered	315
Insurance policy start date	2020-03-01
Insurance policy end date	2021-02-28
Total amount of commissions paid to insurance broker	USD $1,774
Total amount of fees paid to insurance company	USD $83,750
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,594,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,774
Amount paid for insurance broker fees	82941
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	351
Insurance policy start date	2020-03-01
Insurance policy end date	2021-02-28
Total amount of commissions paid to insurance broker	USD $38,043
Total amount of fees paid to insurance company	USD $14,307
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $224,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	121
Insurance policy start date	2020-03-01
Insurance policy end date	2021-02-28
Total amount of commissions paid to insurance broker	USD $2,853
Total amount of fees paid to insurance company	USD $1,434
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	351
Insurance policy start date	2020-03-01
Insurance policy end date	2021-02-28
Total amount of commissions paid to insurance broker	USD $29,198
Total amount of fees paid to insurance company	USD $12,223
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $190,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,030
Amount paid for insurance broker fees	2322
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	121
Insurance policy start date	2020-03-01
Insurance policy end date	2021-02-28
Total amount of commissions paid to insurance broker	USD $2,853
Total amount of fees paid to insurance company	USD $1,434
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,902
Amount paid for insurance broker fees	277
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	401
Insurance policy start date	2019-03-01
Insurance policy end date	2020-02-29
Total amount of commissions paid to insurance broker	USD $34,191
Total amount of fees paid to insurance company	USD $12,912
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $179,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	131
Insurance policy start date	2019-03-01
Insurance policy end date	2020-02-29
Total amount of commissions paid to insurance broker	USD $2,808
Total amount of fees paid to insurance company	USD $1,373
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	131
Insurance policy start date	2019-03-01
Insurance policy end date	2020-02-29
Total amount of commissions paid to insurance broker	USD $2,808
Total amount of fees paid to insurance company	USD $1,373
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,872
Amount paid for insurance broker fees	234
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5951256

Policy instance

Insurance contract or identification number	5951256
Number of Individuals Covered	401
Insurance policy start date	2019-03-01
Insurance policy end date	2020-02-29
Total amount of commissions paid to insurance broker	USD $26,657
Total amount of fees paid to insurance company	USD $10,913
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $150,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,259
Amount paid for insurance broker fees	1892
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

917228

Policy instance

Insurance contract or identification number	917228
Number of Individuals Covered	228
Insurance policy start date	2019-03-01
Insurance policy end date	2020-02-29
Total amount of commissions paid to insurance broker	USD $1,743
Total amount of fees paid to insurance company	USD $72,740
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,400,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,743
Amount paid for insurance broker fees	72740
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

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Company Name:	COMMUNITIES IN SCHOOLS OF HOSTON INC
Employer identification number (EIN):	760031827
NAIC Classification:	624100
NAIC Description:	Individual and Family Services

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1982-08-02
Company Identification Number:	0061715901
Legal Registered Office Address:	1235 NORTH LOOP W STE 300 HOUSTON United States of America (USA) 77008