CUSHING ACADEMY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY
401k plan membership statisitcs for WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY
| Measure | Date | Value |
|---|
| 2022: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-06-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 98 |
| Total of all active and inactive participants | 2022-06-01 | 98 |
| 2021: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-06-01 | 99 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 106 |
| Number of retired or separated participants receiving benefits | 2021-06-01 | 1 |
| Total of all active and inactive participants | 2021-06-01 | 107 |
| 2020: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-06-01 | 92 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 99 |
| Number of retired or separated participants receiving benefits | 2020-06-01 | 1 |
| Total of all active and inactive participants | 2020-06-01 | 100 |
| 2019: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-06-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 92 |
| Total of all active and inactive participants | 2019-06-01 | 92 |
| 2018: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-06-01 | 99 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 98 |
| Number of retired or separated participants receiving benefits | 2018-06-01 | 2 |
| Total of all active and inactive participants | 2018-06-01 | 100 |
| 2017: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-06-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 99 |
| Total of all active and inactive participants | 2017-06-01 | 99 |
| Total participants | 2017-06-01 | 99 |
| 2016: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-06-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 104 |
| Number of retired or separated participants receiving benefits | 2016-06-01 | 0 |
| Total of all active and inactive participants | 2016-06-01 | 104 |
| Total participants | 2016-06-01 | 104 |
| 2015: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 121 |
| Number of retired or separated participants receiving benefits | 2015-06-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 3 |
| Total of all active and inactive participants | 2015-06-01 | 129 |
| Total participants | 2015-06-01 | 129 |
| 2014: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-06-01 | 133 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 129 |
| Number of retired or separated participants receiving benefits | 2014-06-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2014-06-01 | 1 |
| Total of all active and inactive participants | 2014-06-01 | 131 |
| Total participants | 2014-06-01 | 131 |
| 2013: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-06-01 | 137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 130 |
| Number of retired or separated participants receiving benefits | 2013-06-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2013-06-01 | 1 |
| Total of all active and inactive participants | 2013-06-01 | 133 |
| Total participants | 2013-06-01 | 133 |
| 2012: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-06-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 136 |
| Number of retired or separated participants receiving benefits | 2012-06-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2012-06-01 | 0 |
| Total of all active and inactive participants | 2012-06-01 | 137 |
| Total participants | 2012-06-01 | 137 |
| 2011: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-06-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 134 |
| Number of retired or separated participants receiving benefits | 2011-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-06-01 | 0 |
| Total of all active and inactive participants | 2011-06-01 | 134 |
| Total participants | 2011-06-01 | 134 |
| 2009: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-06-01 | 370 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 350 |
| Number of retired or separated participants receiving benefits | 2009-06-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2009-06-01 | 1 |
| Total of all active and inactive participants | 2009-06-01 | 353 |
| Total participants | 2009-06-01 | 353 |
| 2022: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2022 form 5500 responses |
|---|
| 2022-06-01 | Type of plan entity | Single employer plan |
| 2022-06-01 | Plan funding arrangement – Insurance | Yes |
| 2022-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2021 form 5500 responses |
|---|
| 2021-06-01 | Type of plan entity | Single employer plan |
| 2021-06-01 | Plan funding arrangement – Insurance | Yes |
| 2021-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2020 form 5500 responses |
|---|
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | Plan funding arrangement – Insurance | Yes |
| 2020-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2019 form 5500 responses |
|---|
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2018 form 5500 responses |
|---|
| 2018-06-01 | Type of plan entity | Single employer plan |
| 2018-06-01 | Plan funding arrangement – Insurance | Yes |
| 2018-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2017 form 5500 responses |
|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2016 form 5500 responses |
|---|
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2014 form 5500 responses |
|---|
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Plan funding arrangement – Insurance | Yes |
| 2014-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2013 form 5500 responses |
|---|
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | Plan funding arrangement – Insurance | Yes |
| 2013-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2012 form 5500 responses |
|---|
| 2012-06-01 | Type of plan entity | Single employer plan |
| 2012-06-01 | Plan funding arrangement – Insurance | Yes |
| 2012-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2011 form 5500 responses |
|---|
| 2011-06-01 | Type of plan entity | Single employer plan |
| 2011-06-01 | Plan funding arrangement – Insurance | Yes |
| 2011-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: WELFARE BENEFITS PLAN FOR ELIGIBLE EMPLOYEES OF CUSHING ACADEMY 2009 form 5500 responses |
|---|
| 2009-06-01 | Type of plan entity | Single employer plan |
| 2009-06-01 | Plan funding arrangement – Insurance | Yes |
| 2009-06-01 | Plan benefit arrangement – Insurance | Yes |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30067508 |
| Policy instance | 2 |
| Insurance contract or identification number | 30067508 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $740 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,660 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $740 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 1 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $48,896 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,469,819 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $48,896 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30067508 |
| Policy instance | 2 |
| Insurance contract or identification number | 30067508 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | Total amount of commissions paid to insurance broker | USD $757 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,323 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $757 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 1 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | Total amount of commissions paid to insurance broker | USD $67,719 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $67,719 | | Insurance broker organization code? | 3 |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 089079 |
| Policy instance | 1 |
| Insurance contract or identification number | 089079 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $28,818 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,363,190 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,818 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 2 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $3,776 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $88,719 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,776 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30067508 |
| Policy instance | 3 |
| Insurance contract or identification number | 30067508 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $713 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,151 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $713 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30067508 |
| Policy instance | 3 |
| Insurance contract or identification number | 30067508 | | Number of Individuals Covered | 43 | | Total amount of commissions paid to insurance broker | USD $536 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,737 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $536 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 2 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 66 | | Total amount of commissions paid to insurance broker | USD $3,578 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $81,843 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,578 | | Insurance broker organization code? | 3 |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 089079 |
| Policy instance | 1 |
| Insurance contract or identification number | 089079 | | Number of Individuals Covered | 92 | | Total amount of commissions paid to insurance broker | USD $17,411 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,464,890 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,411 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 2 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $3,660 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,073 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,660 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30067508 |
| Policy instance | 3 |
| Insurance contract or identification number | 30067508 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $536 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,718 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $536 |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 089079000 |
| Policy instance | 1 |
| Insurance contract or identification number | 089079000 | | Number of Individuals Covered | 99 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $29,900 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,494,683 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,900 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30067508 |
| Policy instance | 3 |
| Insurance contract or identification number | 30067508 | | Number of Individuals Covered | 42 | | Total amount of commissions paid to insurance broker | USD $459 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $459 | | Insurance broker name | ERIC GULKO |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 089079 |
| Policy instance | 1 |
| Insurance contract or identification number | 089079 | | Number of Individuals Covered | 258 | | Total amount of commissions paid to insurance broker | USD $29,611 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,482,512 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,611 | | Insurance broker name | ERIC GULKO |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 2 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 64 | | Total amount of commissions paid to insurance broker | USD $3,415 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $78,415 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,415 | | Insurance broker name | ERIC GULKO |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 089079 |
| Policy instance | 2 |
| Insurance contract or identification number | 089079 | | Number of Individuals Covered | 304 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $28,090 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,390,753 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,090 | | Insurance broker organization code? | 3 | | Insurance broker name | SUMMIT FINANCIAL INSURANCE AGENCY |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 089080 |
| Policy instance | 1 |
| Insurance contract or identification number | 089080 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $1,879 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $93,033 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,879 | | Insurance broker organization code? | 3 | | Insurance broker name | SUMMIT FINANCIAL INS AGCY INC |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 089080 |
| Policy instance | 1 |
| Insurance contract or identification number | 089080 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $2,016 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,016 | | Insurance broker organization code? | 3 | | Insurance broker name | SUMMIT FINANCIAL INS AGCY INC |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 089079 |
| Policy instance | 2 |
| Insurance contract or identification number | 089079 | | Number of Individuals Covered | 324 | | Total amount of commissions paid to insurance broker | USD $56,831 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $56,831 | | Insurance broker organization code? | 3 | | Insurance broker name | SUMMIT FINANCIAL INSURANCE AGENCY |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 1 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 337 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $37,273 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,370 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | BONUS AND PERSISTENCY COMMISSIONS | | Insurance broker name | SUMMIT FINANCIAL INSURANCE AGENCY |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 1 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 358 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $38,121 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,321 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | BONUS AND PERSISTENCY COMMISSIONS | | Insurance broker name | SUMMIT FINANCIAL INSURANCE AGENCY |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 1 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 359 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $33,982 | | Total amount of fees paid to insurance company | USD $2,282 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4948456 |
| Policy instance | 1 |
| Insurance contract or identification number | 4948456 | | Number of Individuals Covered | 350 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $28,091 | | Total amount of fees paid to insurance company | USD $2,324 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
