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UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 401k Plan overview

Plan NameUNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN
Plan identification number 501

UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN Benefits

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

401k Sponsoring company profile

UNIVERSITY AT BUFFALO NEUROSURGERY, INC. has sponsored the creation of one or more 401k plans.

Company Name:UNIVERSITY AT BUFFALO NEUROSURGERY, INC.
Employer identification number (EIN):030445678
NAIC Classification:611000

Additional information about UNIVERSITY AT BUFFALO NEUROSURGERY, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 2002-05-21
Company Identification Number: 2769637
Legal Registered Office Address: 3 GATES CIRCLE
Erie
BUFFALO
United States of America (USA)
14209

More information about UNIVERSITY AT BUFFALO NEUROSURGERY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-12-01
5012021-12-01
5012020-12-01
5012019-12-01
5012018-12-01
5012017-12-01
5012016-12-01

Plan Statistics for UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN

401k plan membership statisitcs for UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN

Measure Date Value
2022: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-12-01123
Total number of active participants reported on line 7a of the Form 55002022-12-01126
Number of retired or separated participants receiving benefits2022-12-010
Number of other retired or separated participants entitled to future benefits2022-12-010
Total of all active and inactive participants2022-12-01126
2021: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-01111
Total number of active participants reported on line 7a of the Form 55002021-12-01123
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-01123
2020: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01106
Total number of active participants reported on line 7a of the Form 55002020-12-01111
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-01111
2019: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01124
Total number of active participants reported on line 7a of the Form 55002019-12-01106
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01106
2018: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-01113
Total number of active participants reported on line 7a of the Form 55002018-12-01124
Number of retired or separated participants receiving benefits2018-12-010
Number of other retired or separated participants entitled to future benefits2018-12-010
Total of all active and inactive participants2018-12-01124
2017: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-01110
Total number of active participants reported on line 7a of the Form 55002017-12-01113
Number of retired or separated participants receiving benefits2017-12-010
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-01113
2016: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-01110
Total number of active participants reported on line 7a of the Form 55002016-12-01110
Number of retired or separated participants receiving benefits2016-12-010
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-01110

Form 5500 Responses for UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN

2022: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-12-01Type of plan entitySingle employer plan
2022-12-01Submission has been amendedNo
2022-12-01This submission is the final filingNo
2022-12-01This return/report is a short plan year return/report (less than 12 months)No
2022-12-01Plan is a collectively bargained planNo
2022-12-01Plan funding arrangement – InsuranceYes
2022-12-01Plan benefit arrangement – InsuranceYes
2021: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Submission has been amendedNo
2021-12-01This submission is the final filingNo
2021-12-01This return/report is a short plan year return/report (less than 12 months)No
2021-12-01Plan is a collectively bargained planNo
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – InsuranceYes
2020: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Submission has been amendedNo
2020-12-01This submission is the final filingNo
2020-12-01This return/report is a short plan year return/report (less than 12 months)No
2020-12-01Plan is a collectively bargained planNo
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Submission has been amendedNo
2019-12-01This submission is the final filingNo
2019-12-01This return/report is a short plan year return/report (less than 12 months)No
2019-12-01Plan is a collectively bargained planNo
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes
2018: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Submission has been amendedNo
2018-12-01This submission is the final filingNo
2018-12-01This return/report is a short plan year return/report (less than 12 months)No
2018-12-01Plan is a collectively bargained planNo
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan benefit arrangement – InsuranceYes
2017: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Submission has been amendedNo
2017-12-01This submission is the final filingNo
2017-12-01This return/report is a short plan year return/report (less than 12 months)No
2017-12-01Plan is a collectively bargained planNo
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – InsuranceYes
2016: UNIVERSITY AT BUFFALO NEUROSURGERY, INC. HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01First time form 5500 has been submittedYes
2016-12-01Submission has been amendedNo
2016-12-01This submission is the final filingNo
2016-12-01This return/report is a short plan year return/report (less than 12 months)No
2016-12-01Plan is a collectively bargained planNo
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32794
Policy instance 1
Insurance contract or identification number32794
Number of Individuals Covered126
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $70,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL33561
Policy instance 2
Insurance contract or identification numberHCL33561
Number of Individuals Covered125
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $32,543
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $327,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,543
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32794
Policy instance 1
Insurance contract or identification number32794
Number of Individuals Covered123
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $73,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32794
Policy instance 1
Insurance contract or identification number32794
Number of Individuals Covered111
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $60,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32794
Policy instance 1
Insurance contract or identification number32794
Number of Individuals Covered124
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $67,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32794
Policy instance 1
Insurance contract or identification number32794
Number of Individuals Covered113
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $62,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number32794
Policy instance 1
Insurance contract or identification number32794
Number of Individuals Covered110
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $23,988
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $825,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,988
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3

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