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SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN 401k Plan overview

Plan NameSAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN
Plan identification number 501

SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

SAN FRANCISCO ZEN CENTER has sponsored the creation of one or more 401k plans.

Company Name:SAN FRANCISCO ZEN CENTER
Employer identification number (EIN):943143976
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about SAN FRANCISCO ZEN CENTER

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C1519793

More information about SAN FRANCISCO ZEN CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-06-01EMILY HILLDORE DIEBOLT2020-10-08
5012018-06-01EMILY HILLDORE DIEBOLT2020-03-16
5012017-06-01

Plan Statistics for SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN

401k plan membership statisitcs for SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN

Measure Date Value
2019: SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01111
Total number of active participants reported on line 7a of the Form 55002019-06-0157
Number of retired or separated participants receiving benefits2019-06-010
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-0157
Number of employers contributing to the scheme2019-06-010
2018: SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01105
Total number of active participants reported on line 7a of the Form 55002018-06-01111
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01111
Number of employers contributing to the scheme2018-06-010
2017: SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01119
Total number of active participants reported on line 7a of the Form 55002017-06-01128
Number of retired or separated participants receiving benefits2017-06-010
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-01128

Form 5500 Responses for SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN

2019: SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: SAN FRANCISCO ZEN CENTER HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01First time form 5500 has been submittedYes
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30030488
Policy instance 3
Insurance contract or identification number30030488
Number of Individuals Covered73
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $791
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,692
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $791
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number605232
Policy instance 1
Insurance contract or identification number605232
Number of Individuals Covered81
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $25,447
Total amount of fees paid to insurance companyUSD $2
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $508,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,447
Amount paid for insurance broker fees2
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5953903
Policy instance 2
Insurance contract or identification number5953903
Number of Individuals Covered134
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $3,821
Total amount of fees paid to insurance companyUSD $994
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,468
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,821
Amount paid for insurance broker fees994
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30030488
Policy instance 3
Insurance contract or identification number30030488
Number of Individuals Covered91
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $755
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $755
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5953903
Policy instance 2
Insurance contract or identification number5953903
Number of Individuals Covered148
Insurance policy start date2018-09-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $2,710
Total amount of fees paid to insurance companyUSD $963
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,710
Amount paid for insurance broker fees963
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number605232
Policy instance 1
Insurance contract or identification number605232
Number of Individuals Covered92
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $28,831
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $581,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,831
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number19345
Policy instance 4
Insurance contract or identification number19345
Number of Individuals Covered129
Insurance policy start date2018-06-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30030488
Policy instance 3
Insurance contract or identification number30030488
Number of Individuals Covered109
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $804
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,944
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $521
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1060563
Policy instance 2
Insurance contract or identification number1060563
Number of Individuals Covered128
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $3,961
Total amount of fees paid to insurance companyUSD $3,921
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,936
Amount paid for insurance broker fees3921
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number605232
Policy instance 1
Insurance contract or identification number605232
Number of Individuals Covered98
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $31,490
Total amount of fees paid to insurance companyUSD $2,453
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $586,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,032
Amount paid for insurance broker fees2443
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.

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