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HARBOR HOMES, INC. MEDICAL PLAN 401k Plan overview

Plan NameHARBOR HOMES, INC. MEDICAL PLAN
Plan identification number 501

HARBOR HOMES, INC. MEDICAL PLAN Benefits

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

401k Sponsoring company profile

HARBOR HOMES, INC. has sponsored the creation of one or more 401k plans.

Company Name:HARBOR HOMES, INC.
Employer identification number (EIN):020351932
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HARBOR HOMES, INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-01-01JESSICA KEARNS2020-09-11
5012018-03-01
5012017-03-01PETER KELLEHER PETER KELLEHER2018-09-26

Plan Statistics for HARBOR HOMES, INC. MEDICAL PLAN

401k plan membership statisitcs for HARBOR HOMES, INC. MEDICAL PLAN

Measure Date Value
2019: HARBOR HOMES, INC. MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01208
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of employers contributing to the scheme2019-01-010
2018: HARBOR HOMES, INC. MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-03-01141
Total number of active participants reported on line 7a of the Form 55002018-03-01207
Number of retired or separated participants receiving benefits2018-03-011
Total of all active and inactive participants2018-03-01208
2017: HARBOR HOMES, INC. MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-03-01107
Total number of active participants reported on line 7a of the Form 55002017-03-01138
Number of retired or separated participants receiving benefits2017-03-013
Total of all active and inactive participants2017-03-01141

Form 5500 Responses for HARBOR HOMES, INC. MEDICAL PLAN

2019: HARBOR HOMES, INC. MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01This submission is the final filingYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: HARBOR HOMES, INC. MEDICAL PLAN 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Submission has been amendedNo
2018-03-01This submission is the final filingNo
2018-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-03-01Plan is a collectively bargained planNo
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: HARBOR HOMES, INC. MEDICAL PLAN 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01First time form 5500 has been submittedYes
2017-03-01Submission has been amendedNo
2017-03-01This submission is the final filingNo
2017-03-01This return/report is a short plan year return/report (less than 12 months)No
2017-03-01Plan is a collectively bargained planNo
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARVARD PILGRIM HEALTH CARE OF NE, INC. (National Association of Insurance Commissioners NAIC id number: 96917 )
Policy contract number433110000 ET AL
Policy instance 1
Insurance contract or identification number433110000 ET AL
Number of Individuals Covered380
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $64,601
Total amount of fees paid to insurance companyUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $2,328,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $64,601
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARVARD PILGRIM HEALTH CARE OF NE, INC. (National Association of Insurance Commissioners NAIC id number: 96917 )
Policy contract number088004
Policy instance 1
Insurance contract or identification number088004
Number of Individuals Covered380
Insurance policy start date2018-03-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $40,001
Total amount of fees paid to insurance companyUSD $6,682
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,940,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,483
Amount paid for insurance broker fees6682
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
HARVARD PILGRIM HEALTH CARE OF NE, INC. (National Association of Insurance Commissioners NAIC id number: 96917 )
Policy contract number088004
Policy instance 1
Insurance contract or identification number088004
Number of Individuals Covered265
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $41,275
Total amount of fees paid to insurance companyUSD $3,768
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,406,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,170
Amount paid for insurance broker fees3768
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameCROSS INSURANCE

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