PRIMARY CARE HEALTH PARTNERS has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PRIMARY HEALTH CARE PARTNERS HEALTH PLAN
Measure | Date | Value |
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2012: PRIMARY HEALTH CARE PARTNERS HEALTH PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 65 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 58 |
Total of all active and inactive participants | 2012-01-01 | 58 |
Total participants | 2012-01-01 | 0 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
2011: PRIMARY HEALTH CARE PARTNERS HEALTH PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 87 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 65 |
Total of all active and inactive participants | 2011-01-01 | 65 |
Total participants | 2011-01-01 | 65 |
2009: PRIMARY HEALTH CARE PARTNERS HEALTH PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 106 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 90 |
Total of all active and inactive participants | 2009-01-01 | 90 |
Total participants | 2009-01-01 | 90 |
THE VERMONT HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95696 ) |
Policy contract number | 81056 |
Policy instance | 2 |
Insurance contract or identification number | 81056 | Number of Individuals Covered | 57 | Total amount of commissions paid to insurance broker | USD $6,688 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $221,315 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 | 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 | 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 Broker | USD $6,688 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | HICKOK & BOARDMAN FINANCIAL |
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HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | 967548 |
Policy instance | 1 |
Insurance contract or identification number | 967548 | Number of Individuals Covered | 13 | Total amount of commissions paid to insurance broker | USD $4,521 | Welfare Benefit Premiums Paid to Carrier | USD $113,020 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 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 | 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 Broker | USD $4,521 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | NORTHERN INSURANCE AGENCY |
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BLUE CROSS AND BLUE SHIELD OF VERMONT (National Association of Insurance Commissioners NAIC id number: 53295 ) |
Policy contract number | 81056 |
Policy instance | 3 |
Insurance contract or identification number | 81056 | Number of Individuals Covered | 26 | Total amount of commissions paid to insurance broker | USD $5,650 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $178,056 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 | 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 | 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 Broker | USD $5,650 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | HICKOK & BOARDMAN FINANCIAL |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30002499 |
Policy instance | 4 |
Insurance contract or identification number | 30002499 | Number of Individuals Covered | 58 | Total amount of commissions paid to insurance broker | USD $634 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,673 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental 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 | 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 Broker | USD $634 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | HICKOK & BOARDMAN FINANCIAL |
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BLUE CROSS AND BLUE SHIELD OF VERMONT (National Association of Insurance Commissioners NAIC id number: 53295 ) |
Policy contract number | 81056 |
Policy instance | 3 |
Insurance contract or identification number | 81056 | Number of Individuals Covered | 38 | Total amount of commissions paid to insurance broker | USD $8,557 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $271,363 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE VERMONT HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95696 ) |
Policy contract number | 81056 |
Policy instance | 2 |
Insurance contract or identification number | 81056 | Number of Individuals Covered | 55 | Total amount of commissions paid to insurance broker | USD $7,123 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $237,703 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | 967548 |
Policy instance | 1 |
Insurance contract or identification number | 967548 | Number of Individuals Covered | 27 | Total amount of commissions paid to insurance broker | USD $4,168 | Welfare Benefit Premiums Paid to Carrier | USD $104,192 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30002499 |
Policy instance | 4 |
Insurance contract or identification number | 30002499 | Number of Individuals Covered | 70 | Total amount of commissions paid to insurance broker | USD $732 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,900 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30002499 |
Policy instance | 4 |
Insurance contract or identification number | 30002499 | Number of Individuals Covered | 80 | Total amount of commissions paid to insurance broker | USD $809 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,329 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $809 | Insurance broker organization code? | 3 | Insurance broker name | HICKOK & BOARDMAN FINANCIAL |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 520130 |
Policy instance | 5 |
Insurance contract or identification number | 520130 | Number of Individuals Covered | 87 | Total amount of commissions paid to insurance broker | USD $3,731 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,739 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,731 | Insurance broker organization code? | 3 | Insurance broker name | NORTHERN INSURING AGENCY |
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THE VERMONT HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95696 ) |
Policy contract number | 81056 |
Policy instance | 2 |
Insurance contract or identification number | 81056 | Number of Individuals Covered | 55 | Total amount of commissions paid to insurance broker | USD $6,161 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $210,412 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,161 | Insurance broker organization code? | 3 | Insurance broker name | HICKOK & BOARDMAN FINANCIAL |
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HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | 967548 |
Policy instance | 1 |
Insurance contract or identification number | 967548 | Number of Individuals Covered | 7 | Total amount of commissions paid to insurance broker | USD $272 | Welfare Benefit Premiums Paid to Carrier | USD $6,796 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $272 | Insurance broker organization code? | 3 | Insurance broker name | NORTHERN INSURANCY AGENCY |
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BLUE CROSS AND BLUE SHIELD OF VERMONT (National Association of Insurance Commissioners NAIC id number: 53295 ) |
Policy contract number | 81056 |
Policy instance | 3 |
Insurance contract or identification number | 81056 | Number of Individuals Covered | 76 | Total amount of commissions paid to insurance broker | USD $12,501 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $416,145 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,501 | Insurance broker organization code? | 3 | Insurance broker name | HICKOK & BOARDMAN FINANCIAL |
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