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CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameCHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN
Plan identification number 501

CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare 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

CHILD & FAMILY SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:CHILD & FAMILY SERVICES, INC.
Employer identification number (EIN):042104754
NAIC Classification:621112
NAIC Description:Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-10-01ELIZABETH CABRAL2023-12-18
5012021-10-01ELIZABETH CABRAL2023-01-11
5012020-10-01ELIZABETH CABRAL2022-04-17
5012019-10-01ELIZABETH CABRAL2021-02-03
5012018-10-01ELIZABETH CABRAL2020-04-24
5012017-10-01
5012016-10-01JENNIFER FLORES JENNIFER FLORES2018-04-12
5012015-10-01JENNIFER FLORES JENNIFER FLORES2017-03-30
5012014-10-01JENNIFER FLORES JENNIFER FLORES2016-03-22
5012013-10-01JENNIFER FLORES JENNIFER FLORES2015-03-25
5012012-10-01JENNIFER FLORES JENNIFER FLORES2014-02-25
5012011-10-01JENNIFER FLORES JENNIFER FLORES2013-03-25
5012009-10-01JENNIFER FLORES
5012008-10-01JENNIFER FLORES
5012007-10-01JENNIFER FLORES
5012006-10-01JENNIFER FLORES
5012005-10-01JENNIFER FLORES
5012004-10-01JENNIFER FLORES
5012003-10-01JENNIFER FLORES
5012002-10-01JENNIFER FLORES
5012001-10-01JENNIFER FLORES

Plan Statistics for CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN

Measure Date Value
2022: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-01349
Total number of active participants reported on line 7a of the Form 55002022-10-01356
Number of retired or separated participants receiving benefits2022-10-014
Number of other retired or separated participants entitled to future benefits2022-10-010
Total of all active and inactive participants2022-10-01360
Number of employers contributing to the scheme2022-10-010
2021: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01383
Total number of active participants reported on line 7a of the Form 55002021-10-01349
Number of retired or separated participants receiving benefits2021-10-013
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01352
Number of employers contributing to the scheme2021-10-010
2020: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01372
Total number of active participants reported on line 7a of the Form 55002020-10-01383
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01383
Number of employers contributing to the scheme2020-10-010
2019: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01418
Total number of active participants reported on line 7a of the Form 55002019-10-01372
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01372
Number of employers contributing to the scheme2019-10-010
2018: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01410
Total number of active participants reported on line 7a of the Form 55002018-10-01418
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01418
Number of employers contributing to the scheme2018-10-010
2017: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01393
Total number of active participants reported on line 7a of the Form 55002017-10-01410
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-011
Total of all active and inactive participants2017-10-01411
2016: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01414
Total number of active participants reported on line 7a of the Form 55002016-10-01391
Number of retired or separated participants receiving benefits2016-10-011
Total of all active and inactive participants2016-10-01392
2015: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01402
Total number of active participants reported on line 7a of the Form 55002015-10-01413
Number of retired or separated participants receiving benefits2015-10-011
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01414
2014: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01409
Total number of active participants reported on line 7a of the Form 55002014-10-01402
Number of retired or separated participants receiving benefits2014-10-012
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01404
2013: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01243
Total number of active participants reported on line 7a of the Form 55002013-10-01362
Number of retired or separated participants receiving benefits2013-10-011
Number of other retired or separated participants entitled to future benefits2013-10-011
Total of all active and inactive participants2013-10-01364
2012: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01405
Total number of active participants reported on line 7a of the Form 55002012-10-01413
Number of other retired or separated participants entitled to future benefits2012-10-012
Total of all active and inactive participants2012-10-01415
2011: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01340
Total number of active participants reported on line 7a of the Form 55002011-10-01393
Number of retired or separated participants receiving benefits2011-10-011
Number of other retired or separated participants entitled to future benefits2011-10-0111
Total of all active and inactive participants2011-10-01405
2009: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01264
Total number of active participants reported on line 7a of the Form 55002009-10-01261
Number of retired or separated participants receiving benefits2009-10-010
Number of other retired or separated participants entitled to future benefits2009-10-013
Total of all active and inactive participants2009-10-01264
Total participants2009-10-01264
2008: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-10-01228
Total number of active participants reported on line 7a of the Form 55002008-10-01264
Number of retired or separated participants receiving benefits2008-10-011
Number of other retired or separated participants entitled to future benefits2008-10-013
Total of all active and inactive participants2008-10-01268
Total participants2008-10-01268
2007: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-10-01197
Total number of active participants reported on line 7a of the Form 55002007-10-01228
Number of retired or separated participants receiving benefits2007-10-014
Number of other retired or separated participants entitled to future benefits2007-10-013
Total of all active and inactive participants2007-10-01235
Total participants2007-10-01235
2006: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-10-01165
Total number of active participants reported on line 7a of the Form 55002006-10-01197
Number of retired or separated participants receiving benefits2006-10-011
Number of other retired or separated participants entitled to future benefits2006-10-012
Total of all active and inactive participants2006-10-01200
Total participants2006-10-01200
2005: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-10-01157
Total number of active participants reported on line 7a of the Form 55002005-10-01165
Total of all active and inactive participants2005-10-01165
Total participants2005-10-01165
2004: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2004 401k membership
Total participants, beginning-of-year2004-10-01135
Total number of active participants reported on line 7a of the Form 55002004-10-01157
Total of all active and inactive participants2004-10-01157
Total participants2004-10-01157
2003: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2003 401k membership
Total participants, beginning-of-year2003-10-01163
Total number of active participants reported on line 7a of the Form 55002003-10-01135
Total of all active and inactive participants2003-10-01135
Total participants2003-10-01135
2002: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2002 401k membership
Total participants, beginning-of-year2002-10-01162
Total number of active participants reported on line 7a of the Form 55002002-10-01163
Total of all active and inactive participants2002-10-01163
Total participants2002-10-01163
2001: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2001 401k membership
Total participants, beginning-of-year2001-10-01159
Total number of active participants reported on line 7a of the Form 55002001-10-01162
Total of all active and inactive participants2001-10-01162
Total participants2001-10-01162

Form 5500 Responses for CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN

2022: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan funding arrangement – General assets of the sponsorYes
2022-10-01Plan benefit arrangement – InsuranceYes
2022-10-01Plan benefit arrangement – General assets of the sponsorYes
2021: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2009: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – InsuranceYes
2008: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2008 form 5500 responses
2008-10-01Type of plan entitySingle employer plan
2008-10-01Submission has been amendedNo
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)No
2008-10-01Plan is a collectively bargained planNo
2008-10-01Plan funding arrangement – InsuranceYes
2008-10-01Plan benefit arrangement – InsuranceYes
2007: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2007 form 5500 responses
2007-10-01Type of plan entitySingle employer plan
2007-10-01Submission has been amendedNo
2007-10-01This submission is the final filingNo
2007-10-01This return/report is a short plan year return/report (less than 12 months)No
2007-10-01Plan is a collectively bargained planNo
2007-10-01Plan funding arrangement – InsuranceYes
2007-10-01Plan benefit arrangement – InsuranceYes
2006: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2006 form 5500 responses
2006-10-01Type of plan entitySingle employer plan
2006-10-01Submission has been amendedNo
2006-10-01This submission is the final filingNo
2006-10-01This return/report is a short plan year return/report (less than 12 months)No
2006-10-01Plan is a collectively bargained planNo
2006-10-01Plan funding arrangement – InsuranceYes
2006-10-01Plan benefit arrangement – InsuranceYes
2005: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2005 form 5500 responses
2005-10-01Type of plan entitySingle employer plan
2005-10-01Submission has been amendedNo
2005-10-01This submission is the final filingNo
2005-10-01This return/report is a short plan year return/report (less than 12 months)No
2005-10-01Plan is a collectively bargained planNo
2005-10-01Plan funding arrangement – InsuranceYes
2005-10-01Plan benefit arrangement – InsuranceYes
2004: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2004 form 5500 responses
2004-10-01Type of plan entitySingle employer plan
2004-10-01Submission has been amendedNo
2004-10-01This submission is the final filingNo
2004-10-01This return/report is a short plan year return/report (less than 12 months)No
2004-10-01Plan is a collectively bargained planNo
2004-10-01Plan funding arrangement – InsuranceYes
2004-10-01Plan benefit arrangement – InsuranceYes
2003: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2003 form 5500 responses
2003-10-01Type of plan entitySingle employer plan
2003-10-01Submission has been amendedNo
2003-10-01This submission is the final filingNo
2003-10-01This return/report is a short plan year return/report (less than 12 months)No
2003-10-01Plan is a collectively bargained planNo
2003-10-01Plan funding arrangement – InsuranceYes
2003-10-01Plan benefit arrangement – InsuranceYes
2002: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2002 form 5500 responses
2002-10-01Type of plan entitySingle employer plan
2002-10-01Submission has been amendedNo
2002-10-01This submission is the final filingNo
2002-10-01This return/report is a short plan year return/report (less than 12 months)No
2002-10-01Plan is a collectively bargained planNo
2002-10-01Plan funding arrangement – InsuranceYes
2002-10-01Plan benefit arrangement – InsuranceYes
2001: CHILD & FAMILY SERVICES, INC. WELFARE BENEFIT PLAN 2001 form 5500 responses
2001-10-01Type of plan entitySingle employer plan
2001-10-01First time form 5500 has been submittedYes
2001-10-01Submission has been amendedNo
2001-10-01This submission is the final filingNo
2001-10-01This return/report is a short plan year return/report (less than 12 months)No
2001-10-01Plan is a collectively bargained planNo
2001-10-01Plan funding arrangement – InsuranceYes
2001-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL151785
Policy instance 3
Insurance contract or identification numberGL151785
Number of Individuals Covered356
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $6,805
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $81,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,805
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10339441001
Policy instance 2
Insurance contract or identification number10339441001
Number of Individuals Covered520
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $2,262
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,262
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number15721
Policy instance 1
Insurance contract or identification number15721
Number of Individuals Covered344
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $5,290
Total amount of fees paid to insurance companyUSD $1,848
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $150,494
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,290
Amount paid for insurance broker fees1848
Additional information about fees paid to insurance brokerOTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL151785
Policy instance 3
Insurance contract or identification numberGL151785
Number of Individuals Covered349
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $5,584
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $56,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,584
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10339441001
Policy instance 2
Insurance contract or identification number10339441001
Number of Individuals Covered236
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $1,191
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,191
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05954128
Policy instance 1
Insurance contract or identification numberTM05954128
Number of Individuals Covered361
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $4,168
Total amount of fees paid to insurance companyUSD $2,387
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $155,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,168
Amount paid for insurance broker fees2387
Additional information about fees paid to insurance brokerSUPPLEMENTAL/NON-MONETARY COMPENSATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL151785
Policy instance 2
Insurance contract or identification numberGL151785
Number of Individuals Covered383
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $5,755
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $60,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,755
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05954128
Policy instance 1
Insurance contract or identification numberTM05954128
Number of Individuals Covered368
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $4,581
Total amount of fees paid to insurance companyUSD $3,089
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $179,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,581
Amount paid for insurance broker fees3089
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION ADDITIONAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL151785
Policy instance 2
Insurance contract or identification numberGL151785
Number of Individuals Covered372
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $5,964
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $64,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,964
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5954128
Policy instance 1
Insurance contract or identification number5954128
Number of Individuals Covered399
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $4,403
Total amount of fees paid to insurance companyUSD $2,281
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,403
Amount paid for insurance broker fees2281
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL151785
Policy instance 2
Insurance contract or identification numberGL151785
Number of Individuals Covered418
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $6,398
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $72,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,398
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5954128
Policy instance 1
Insurance contract or identification number5954128
Number of Individuals Covered367
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $4,132
Total amount of fees paid to insurance companyUSD $510
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $152,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,132
Amount paid for insurance broker fees510
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-006420
Policy instance 4
Insurance contract or identification number136-006420
Number of Individuals Covered484
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $4,054
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $146,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD124506
Policy instance 3
Insurance contract or identification numberLTD124506
Number of Individuals Covered410
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $3,862
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberHP-0023
Policy instance 2
Insurance contract or identification numberHP-0023
Number of Individuals Covered410
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $64,331
Total amount of fees paid to insurance companyUSD $21,189
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $364,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL151785
Policy instance 1
Insurance contract or identification numberGL151785
Number of Individuals Covered410
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $1,910
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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