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VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameVINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN
Plan identification number 501

VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

VINFEN CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:VINFEN CORPORATION
Employer identification number (EIN):042632219
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about VINFEN CORPORATION

Jurisdiction of Incorporation: Commonwealth of Massachusetts Corporations Division
Incorporation Date:
Company Identification Number: 042632219

More information about VINFEN CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-09-01ANNETTE KOVAMEES2024-03-08
5012021-09-01RICHARD SULLIVAN2022-12-27
5012020-09-01RICHARD SULLIVAN2022-03-22
5012020-09-01RICHARD SULLIVAN2022-12-27
5012019-09-01RICHARD SULLIVAN2021-06-15
5012018-09-01RICHARD SULLIVAN2020-02-28
5012017-09-01RICHARD SULLIVAN2019-06-11
5012016-09-01
5012015-09-01RICHARD SULLIVAN
5012014-09-01BRIGITTE BECKLES
5012013-09-01BRIGITTE BECKLES
5012012-09-01BRIGITTE BECKLES
5012011-09-01BRIGITTE BECKLES
5012009-09-01SARA CLAYTON
5012009-09-01SARA CLAYTON

Plan Statistics for VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN

401k plan membership statisitcs for VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN

Measure Date Value
2022: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-09-011,198
Total number of active participants reported on line 7a of the Form 55002022-09-012,123
Number of retired or separated participants receiving benefits2022-09-0122
Number of other retired or separated participants entitled to future benefits2022-09-010
Total of all active and inactive participants2022-09-012,145
Number of employers contributing to the scheme2022-09-010
2021: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-011,256
Total number of active participants reported on line 7a of the Form 55002021-09-011,239
Number of retired or separated participants receiving benefits2021-09-0110
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-011,249
Number of employers contributing to the scheme2021-09-010
2020: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-011,286
Total number of active participants reported on line 7a of the Form 55002020-09-011,245
Number of retired or separated participants receiving benefits2020-09-0111
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-011,256
Number of employers contributing to the scheme2020-09-010
2019: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-011,966
Total number of active participants reported on line 7a of the Form 55002019-09-011,283
Number of retired or separated participants receiving benefits2019-09-013
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-011,286
Number of employers contributing to the scheme2019-09-010
2018: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-012,015
Total number of active participants reported on line 7a of the Form 55002018-09-011,966
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-011,966
Number of employers contributing to the scheme2018-09-010
2017: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-011,495
Total number of active participants reported on line 7a of the Form 55002017-09-011,965
Number of retired or separated participants receiving benefits2017-09-0150
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-012,015
Number of employers contributing to the scheme2017-09-010
2016: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-011,158
Total number of active participants reported on line 7a of the Form 55002016-09-012,981
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-012,981
2015: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-011,046
Total number of active participants reported on line 7a of the Form 55002015-09-011,158
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-011,158
2014: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-011,715
Total number of active participants reported on line 7a of the Form 55002014-09-011,036
Number of retired or separated participants receiving benefits2014-09-0110
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-011,046
2013: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-011,593
Total number of active participants reported on line 7a of the Form 55002013-09-011,705
Number of retired or separated participants receiving benefits2013-09-0110
Number of other retired or separated participants entitled to future benefits2013-09-010
Total of all active and inactive participants2013-09-011,715
2012: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-011,431
Total number of active participants reported on line 7a of the Form 55002012-09-011,583
Number of retired or separated participants receiving benefits2012-09-0110
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-011,593
2011: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-011,543
Total number of active participants reported on line 7a of the Form 55002011-09-011,421
Number of retired or separated participants receiving benefits2011-09-0110
Number of other retired or separated participants entitled to future benefits2011-09-010
Total of all active and inactive participants2011-09-011,431
2009: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-011,473
Total number of active participants reported on line 7a of the Form 55002009-09-011,548
Number of retired or separated participants receiving benefits2009-09-0123
Number of other retired or separated participants entitled to future benefits2009-09-010
Total of all active and inactive participants2009-09-011,571

Form 5500 Responses for VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN

2022: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan funding arrangement – General assets of the sponsorYes
2022-09-01Plan benefit arrangement – InsuranceYes
2022-09-01Plan benefit arrangement – General assets of the sponsorYes
2021: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan funding arrangement – General assets of the sponsorYes
2021-09-01Plan benefit arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – General assets of the sponsorYes
2020: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedYes
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan funding arrangement – General assets of the sponsorYes
2020-09-01Plan benefit arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – General assets of the sponsorYes
2019: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan funding arrangement – General assets of the sponsorYes
2019-09-01Plan benefit arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – General assets of the sponsorYes
2018: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan funding arrangement – General assets of the sponsorYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – General assets of the sponsorYes
2017: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan funding arrangement – General assets of the sponsorYes
2017-09-01Plan benefit arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – General assets of the sponsorYes
2016: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan funding arrangement – General assets of the sponsorYes
2016-09-01Plan benefit arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – General assets of the sponsorYes
2015: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan funding arrangement – General assets of the sponsorYes
2015-09-01Plan benefit arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – General assets of the sponsorYes
2014: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan funding arrangement – General assets of the sponsorYes
2014-09-01Plan benefit arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – General assets of the sponsorYes
2013: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan funding arrangement – General assets of the sponsorYes
2013-09-01Plan benefit arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – General assets of the sponsorYes
2012: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – General assets of the sponsorYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – General assets of the sponsorYes
2011: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan funding arrangement – General assets of the sponsorYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – General assets of the sponsorYes
2009: VINFEN CORPORATION GROUP HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan funding arrangement – General assets of the sponsorYes
2009-09-01Plan benefit arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965007
Policy instance 4
Insurance contract or identification numberLK965007
Number of Individuals Covered2123
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $30,497
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $629,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $30,497
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number107639 ET AL
Policy instance 3
Insurance contract or identification number107639 ET AL
Number of Individuals Covered1902
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $352,134
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $18,182,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $352,134
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 number228145
Policy instance 2
Insurance contract or identification number228145
Number of Individuals Covered1840
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $19,018
Total amount of fees paid to insurance companyUSD $16,433
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $955,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,018
Amount paid for insurance broker fees16433
Additional information about fees paid to insurance brokerSUPPLEMENTAL/ NON-MONETARY COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98540351001
Policy instance 1
Insurance contract or identification number98540351001
Number of Individuals Covered1594
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $7,327
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,327
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number98540351001
Policy instance 1
Insurance contract or identification number98540351001
Number of Individuals Covered1579
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $18,919
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $84,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,919
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 number228145
Policy instance 2
Insurance contract or identification number228145
Number of Individuals Covered1783
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $25,941
Total amount of fees paid to insurance companyUSD $4,917
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $926,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,941
Amount paid for insurance broker fees4917
Additional information about fees paid to insurance brokerSUPPLEMENTAL/NON-MONETARY COMPENSATION
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965007
Policy instance 3
Insurance contract or identification numberLK965007
Number of Individuals Covered1239
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $27,719
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $735,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $27,719
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number107639 ET
Policy instance 4
Insurance contract or identification number107639 ET
Number of Individuals Covered1239
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $368,708
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $15,885,236
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $368,708
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965007
Policy instance 6
Insurance contract or identification numberLK965007
Number of Individuals Covered1245
Insurance policy start date2021-01-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $10,094
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 providedEMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $278,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $10,094
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number107639 ET AL
Policy instance 5
Insurance contract or identification number107639 ET AL
Number of Individuals Covered1330
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $251,217
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $16,155,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $251,217
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965007
Policy instance 4
Insurance contract or identification numberLK965007
Number of Individuals Covered1245
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $24,474
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 providedEMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $555,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $24,474
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 number228145
Policy instance 3
Insurance contract or identification number228145
Number of Individuals Covered1170
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $4,290
Total amount of fees paid to insurance companyUSD $21
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $961,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,290
Amount paid for insurance broker fees21
Additional information about fees paid to insurance brokerOTHER
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960970
Policy instance 2
Insurance contract or identification numberFLK960970
Number of Individuals Covered1245
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $4,475
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $205,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,475
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number98540351001
Policy instance 1
Insurance contract or identification number98540351001
Number of Individuals Covered1616
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $84,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965007
Policy instance 3
Insurance contract or identification numberLK965007
Number of Individuals Covered1283
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $30,801
Total amount of fees paid to insurance companyUSD $8,318
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $939,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $30,801
Amount paid for insurance broker fees8318
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number98540351001
Policy instance 2
Insurance contract or identification number98540351001
Number of Individuals Covered1741
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $5,362
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $100,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,362
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4958134
Policy instance 1
Insurance contract or identification number4958134
Number of Individuals Covered2163
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $224,786
Total amount of fees paid to insurance companyUSD $80,764
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $224,786
Amount paid for insurance broker fees80764
Additional information about fees paid to insurance brokerOTHER COMMISSION NON-MONETARY COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number98540351001
Policy instance 2
Insurance contract or identification number98540351001
Number of Individuals Covered1728
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $4,296
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $95,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,296
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA-LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967289
Policy instance 3
Insurance contract or identification numberFLX967289
Number of Individuals Covered2124
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $19,579
Total amount of fees paid to insurance companyUSD $4,984
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $717,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $19,579
Amount paid for insurance broker fees4984
Additional information about fees paid to insurance brokerOVERIDE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4958134
Policy instance 1
Insurance contract or identification number4958134
Number of Individuals Covered2151
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $207,730
Total amount of fees paid to insurance companyUSD $85,249
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $207,730
Amount paid for insurance broker fees85249
Additional information about fees paid to insurance brokerOTHER COMMISSION NON-MONETARY COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number98540351001
Policy instance 2
Insurance contract or identification number98540351001
Number of Individuals Covered1621
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $6,262
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,169
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 number4958134
Policy instance 1
Insurance contract or identification number4958134
Number of Individuals Covered2044
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $297,206
Total amount of fees paid to insurance companyUSD $295
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967289
Policy instance 3
Insurance contract or identification numberFLX967289
Number of Individuals Covered1965
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $19,587
Total amount of fees paid to insurance companyUSD $15,920
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $633,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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