401k Plan data: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN plan

PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN
Plan identification number	506

PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

PROCTOR ACADEMY has sponsored the creation of one or more 401k plans.

Company Name: PROCTOR ACADEMY

Employer identification number (EIN): 020222179

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2022-07-01 STEPHANIE BEAUDET 2024-01-31
506 2021-07-01 STEPHANIE M. BEAUDET 2023-04-12
506 2020-07-01
506 2019-07-01
506 2017-07-01 JOHN FERRIS JOHN FERRIS 2019-03-11
506 2016-07-01 JOHN FERRIS JOHN FERRIS 2018-01-29
506 2015-07-01 JOHN FERRIS JOHN FERRIS 2017-01-19
506 2014-07-01 JOHN FERRIS JOHN FERRIS 2016-01-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
506	2022-07-01	STEPHANIE BEAUDET	2024-01-31
506	2021-07-01	STEPHANIE M. BEAUDET	2023-04-12
506	2020-07-01
506	2019-07-01
506	2017-07-01	JOHN FERRIS		JOHN FERRIS	2019-03-11
506	2016-07-01	JOHN FERRIS		JOHN FERRIS	2018-01-29
506	2015-07-01	JOHN FERRIS		JOHN FERRIS	2017-01-19
506	2014-07-01	JOHN FERRIS		JOHN FERRIS	2016-01-22

Plan Statistics for PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2022: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-07-01 173
Total number of active participants reported on line 7a of the Form 5500 2022-07-01 172
Number of retired or separated participants receiving benefits 2022-07-01 0
Number of other retired or separated participants entitled to future benefits 2022-07-01 0
Total of all active and inactive participants 2022-07-01 172
Number of employers contributing to the scheme 2022-07-01 0
2021: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 136
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 173
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 0
Total of all active and inactive participants 2021-07-01 173
Number of employers contributing to the scheme 2021-07-01 0
2020: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 147
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 131
Number of retired or separated participants receiving benefits 2020-07-01 2
Number of other retired or separated participants entitled to future benefits 2020-07-01 3
Total of all active and inactive participants 2020-07-01 136
2019: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 152
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 140
Number of retired or separated participants receiving benefits 2019-07-01 4
Number of other retired or separated participants entitled to future benefits 2019-07-01 3
Total of all active and inactive participants 2019-07-01 147
2017: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 128
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 125
Number of retired or separated participants receiving benefits 2017-07-01 1
Number of other retired or separated participants entitled to future benefits 2017-07-01 1
Total of all active and inactive participants 2017-07-01 127
2016: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 128
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 124
Number of retired or separated participants receiving benefits 2016-07-01 3
Number of other retired or separated participants entitled to future benefits 2016-07-01 1
Total of all active and inactive participants 2016-07-01 128
2015: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 128
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 123
Number of retired or separated participants receiving benefits 2015-07-01 5
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 128
2014: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 127
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 123
Number of retired or separated participants receiving benefits 2014-07-01 5
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 128

Measure	Date	Value
2022: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-07-01	173
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	172
Number of retired or separated participants receiving benefits	2022-07-01	0
Number of other retired or separated participants entitled to future benefits	2022-07-01	0
Total of all active and inactive participants	2022-07-01	172
Number of employers contributing to the scheme	2022-07-01	0
2021: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	136
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	173
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	0
Total of all active and inactive participants	2021-07-01	173
Number of employers contributing to the scheme	2021-07-01	0
2020: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	147
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	131
Number of retired or separated participants receiving benefits	2020-07-01	2
Number of other retired or separated participants entitled to future benefits	2020-07-01	3
Total of all active and inactive participants	2020-07-01	136
2019: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	152
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	140
Number of retired or separated participants receiving benefits	2019-07-01	4
Number of other retired or separated participants entitled to future benefits	2019-07-01	3
Total of all active and inactive participants	2019-07-01	147
2017: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	128
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	125
Number of retired or separated participants receiving benefits	2017-07-01	1
Number of other retired or separated participants entitled to future benefits	2017-07-01	1
Total of all active and inactive participants	2017-07-01	127
2016: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	128
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	124
Number of retired or separated participants receiving benefits	2016-07-01	3
Number of other retired or separated participants entitled to future benefits	2016-07-01	1
Total of all active and inactive participants	2016-07-01	128
2015: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	128
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	123
Number of retired or separated participants receiving benefits	2015-07-01	5
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	128
2014: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	127
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	123
Number of retired or separated participants receiving benefits	2014-07-01	5
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	128

Form 5500 Responses for PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN

2022: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-07-01	Type of plan entity	Single employer plan
2022-07-01	Plan funding arrangement – Insurance	Yes
2022-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-07-01	Plan benefit arrangement – Insurance	Yes
2022-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: PROCTOR ACADEMY HEALTH AND WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	First time form 5500 has been submitted	Yes
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0B7HB
Policy instance	2
NORTHEAST DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 47079 )
Policy contract number	11702
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0B7HB
Policy instance	2
NORTHEAST DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 47079 )
Policy contract number	11702
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0B7HB
Policy instance	4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLTD0B7HB
Policy instance	3
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract number	EMCL20100198007
Policy instance	2
NORTHEAST DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 47079 )
Policy contract number	000011702
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0B7HB
Policy instance	4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLTD0B7HB
Policy instance	3
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract number	EMCL18100198005
Policy instance	2
NORTHEAST DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 47079 )
Policy contract number	000011702
Policy instance	1
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract number	EMCL14100198001
Policy instance	1
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract number	EMCL14100198001
Policy instance	1

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Company Name:	PROCTOR ACADEMY
Employer identification number (EIN):	020222179
NAIC Classification:	611000