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HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameHARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN
Plan identification number 501

HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Long-term disability cover

401k Sponsoring company profile

HARBOR MEDICAL ASSOCIATES, P.C. has sponsored the creation of one or more 401k plans.

Company Name:HARBOR MEDICAL ASSOCIATES, P.C.
Employer identification number (EIN):042702579
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012014-08-01LISA DUBE
5012013-08-01LISA DUBE
5012012-08-01ROBERT ONEILL
5012011-08-01ROBERT ONEILL
5012010-08-01ROBERT O'NEILL
5012009-08-01ROBERT O'NEILL
5012008-08-01ROBERT ONEILL
5012007-08-01ROBERT ONEILL
5012006-08-01ROBERT ONEILL ROBERT ONEILL2012-08-28
5012005-08-01ROBERT ONEILL ROBERT ONEILL2012-08-28
5012004-08-01ROBERT ONEILL ROBERT ONEILL2012-08-28

Plan Statistics for HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN

Measure Date Value
2014: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01485
Total number of active participants reported on line 7a of the Form 55002014-08-01519
Total of all active and inactive participants2014-08-01519
Total participants2014-08-01519
2013: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01482
Total number of active participants reported on line 7a of the Form 55002013-08-01485
Total of all active and inactive participants2013-08-01485
Total participants2013-08-01485
2012: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01439
Total number of active participants reported on line 7a of the Form 55002012-08-01475
Number of retired or separated participants receiving benefits2012-08-017
Total of all active and inactive participants2012-08-01482
Total participants2012-08-01482
2011: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01316
Total number of active participants reported on line 7a of the Form 55002011-08-01434
Number of retired or separated participants receiving benefits2011-08-015
Total of all active and inactive participants2011-08-01439
Total participants2011-08-01439
2010: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-08-01351
Total number of active participants reported on line 7a of the Form 55002010-08-01279
Number of retired or separated participants receiving benefits2010-08-0110
Number of other retired or separated participants entitled to future benefits2010-08-0127
Total of all active and inactive participants2010-08-01316
Total participants2010-08-01316
2009: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01315
Total number of active participants reported on line 7a of the Form 55002009-08-01279
Number of retired or separated participants receiving benefits2009-08-0114
Number of other retired or separated participants entitled to future benefits2009-08-0158
Total of all active and inactive participants2009-08-01351
Total participants2009-08-01351
2008: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-08-01254
Total number of active participants reported on line 7a of the Form 55002008-08-01273
Number of retired or separated participants receiving benefits2008-08-018
Number of other retired or separated participants entitled to future benefits2008-08-0134
Total of all active and inactive participants2008-08-01315
Total participants2008-08-01315
2007: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-08-01231
Total number of active participants reported on line 7a of the Form 55002007-08-01221
Number of retired or separated participants receiving benefits2007-08-0111
Number of other retired or separated participants entitled to future benefits2007-08-0122
Total of all active and inactive participants2007-08-01254
Total participants2007-08-01254
2006: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-08-01174
Total number of active participants reported on line 7a of the Form 55002006-08-01221
Number of retired or separated participants receiving benefits2006-08-015
Number of other retired or separated participants entitled to future benefits2006-08-015
Total of all active and inactive participants2006-08-01231
Total participants2006-08-01231
2005: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-08-01164
Total number of active participants reported on line 7a of the Form 55002005-08-01160
Number of retired or separated participants receiving benefits2005-08-015
Number of other retired or separated participants entitled to future benefits2005-08-019
Total of all active and inactive participants2005-08-01174
Total participants2005-08-01174
2004: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2004 401k membership
Total participants, beginning-of-year2004-08-010
Total number of active participants reported on line 7a of the Form 55002004-08-01151
Number of retired or separated participants receiving benefits2004-08-015
Number of other retired or separated participants entitled to future benefits2004-08-018
Total of all active and inactive participants2004-08-01164
Total participants2004-08-01164

Form 5500 Responses for HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN

2014: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes
2013: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – General assets of the sponsorYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – General assets of the sponsorYes
2011: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Submission has been amendedNo
2011-08-01This submission is the final filingNo
2011-08-01This return/report is a short plan year return/report (less than 12 months)No
2011-08-01Plan is a collectively bargained planNo
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan funding arrangement – General assets of the sponsorYes
2011-08-01Plan benefit arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – General assets of the sponsorYes
2010: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan funding arrangement – General assets of the sponsorYes
2010-08-01Plan benefit arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – General assets of the sponsorYes
2009: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan funding arrangement – General assets of the sponsorYes
2009-08-01Plan benefit arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – General assets of the sponsorYes
2008: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2008 form 5500 responses
2008-08-01Type of plan entitySingle employer plan
2008-08-01Submission has been amendedNo
2008-08-01This submission is the final filingNo
2008-08-01This return/report is a short plan year return/report (less than 12 months)No
2008-08-01Plan is a collectively bargained planNo
2008-08-01Plan funding arrangement – InsuranceYes
2008-08-01Plan funding arrangement – General assets of the sponsorYes
2008-08-01Plan benefit arrangement – InsuranceYes
2008-08-01Plan benefit arrangement – General assets of the sponsorYes
2007: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2007 form 5500 responses
2007-08-01Type of plan entitySingle employer plan
2007-08-01Submission has been amendedYes
2007-08-01This submission is the final filingNo
2007-08-01This return/report is a short plan year return/report (less than 12 months)No
2007-08-01Plan is a collectively bargained planNo
2007-08-01Plan funding arrangement – InsuranceYes
2007-08-01Plan funding arrangement – General assets of the sponsorYes
2007-08-01Plan benefit arrangement – InsuranceYes
2007-08-01Plan benefit arrangement – General assets of the sponsorYes
2006: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2006 form 5500 responses
2006-08-01Type of plan entitySingle employer plan
2006-08-01Submission has been amendedNo
2006-08-01This submission is the final filingNo
2006-08-01This return/report is a short plan year return/report (less than 12 months)No
2006-08-01Plan is a collectively bargained planNo
2006-08-01Plan funding arrangement – InsuranceYes
2006-08-01Plan funding arrangement – General assets of the sponsorYes
2006-08-01Plan benefit arrangement – InsuranceYes
2006-08-01Plan benefit arrangement – General assets of the sponsorYes
2005: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2005 form 5500 responses
2005-08-01Type of plan entitySingle employer plan
2005-08-01Submission has been amendedNo
2005-08-01This submission is the final filingNo
2005-08-01This return/report is a short plan year return/report (less than 12 months)No
2005-08-01Plan is a collectively bargained planNo
2005-08-01Plan funding arrangement – InsuranceYes
2005-08-01Plan funding arrangement – General assets of the sponsorYes
2005-08-01Plan benefit arrangement – InsuranceYes
2005-08-01Plan benefit arrangement – General assets of the sponsorYes
2004: HARBOR MEDICAL ASSOCIATES, P.C. EMPLOYEE BENEFIT PLAN 2004 form 5500 responses
2004-08-01Type of plan entitySingle employer plan
2004-08-01First time form 5500 has been submittedYes
2004-08-01Submission has been amendedNo
2004-08-01This submission is the final filingNo
2004-08-01This return/report is a short plan year return/report (less than 12 months)No
2004-08-01Plan is a collectively bargained planNo
2004-08-01Plan funding arrangement – InsuranceYes
2004-08-01Plan funding arrangement – General assets of the sponsorYes
2004-08-01Plan benefit arrangement – InsuranceYes
2004-08-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number012594
Policy instance 1
Insurance contract or identification number012594
Number of Individuals Covered541
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $9,467
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $239,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,467
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCLARK & LAVEY BENEFITS SOLUTIONS
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number052341
Policy instance 3
Insurance contract or identification number052341
Number of Individuals Covered519
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $47,526
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,191,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,526
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCLARK & LAVEY BENEFITS SOLUTIONS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082122
Policy instance 2
Insurance contract or identification number000010082122
Number of Individuals Covered243
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $9,158
Total amount of fees paid to insurance companyUSD $525
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $121,592
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,158
Amount paid for insurance broker fees525
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameCLARK & LAVEY BENEFITS SOLUTIONS
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number052341
Policy instance 1
Insurance contract or identification number052341
Number of Individuals Covered485
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $45,028
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,749,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,028
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCLARK & LAVEY BENEFITS SOLUTIONS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082122
Policy instance 2
Insurance contract or identification number000010082122
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $7,330
Total amount of fees paid to insurance companyUSD $2,303
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $102,711
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,330
Amount paid for insurance broker fees2303
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameCLARK & LAVEY BENEFITS SOLUTIONS
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number012594
Policy instance 3
Insurance contract or identification number012594
Number of Individuals Covered544
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $6,757
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $223,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,757
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCLARK & LAVEY BENEFITS SOLUTIONS
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number052341
Policy instance 1
Insurance contract or identification number052341
Number of Individuals Covered482
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $42,326
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,732,229
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,326
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCLARK & LAVEY BENEFITS SOLUTIONS
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number012594
Policy instance 3
Insurance contract or identification number012594
Number of Individuals Covered539
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $6,314
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $200,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,314
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCLARK & LAVEY BENEFITS SOLUTIONS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082122
Policy instance 2
Insurance contract or identification number000010082122
Number of Individuals Covered281
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $7,288
Total amount of fees paid to insurance companyUSD $4,493
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $98,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees390
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameCLARK & LAVEY BENEFITS SOLUTIONS
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number052341
Policy instance 1
Insurance contract or identification number052341
Number of Individuals Covered434
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $43,454
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,844,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082122
Policy instance 2
Insurance contract or identification number000010082122
Number of Individuals Covered275
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $7,176
Total amount of fees paid to insurance companyUSD $3,741
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $90,777
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 number4956959
Policy instance 3
Insurance contract or identification number4956959
Number of Individuals Covered512
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $6,132
Total amount of fees paid to insurance companyUSD $756
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $184,092
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 number0552250000
Policy instance 4
Insurance contract or identification number0552250000
Number of Individuals Covered60
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of fees paid to insurance companyUSD $4,512
Welfare Benefit Premiums Paid to CarrierUSD $285,101
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 number0523410001
Policy instance 6
Insurance contract or identification number0523410001
Number of Individuals Covered2
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of fees paid to insurance companyUSD $886
Welfare Benefit Premiums Paid to CarrierUSD $58,561
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number000382
Policy instance 1
Insurance contract or identification number000382
Number of Individuals Covered480
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $2,495
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $176,658
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 number0523420001
Policy instance 2
Insurance contract or identification number0523420001
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082122
Policy instance 9
Insurance contract or identification number000010082122
Number of Individuals Covered258
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $2,549
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082123
Policy instance 8
Insurance contract or identification number000010082123
Number of Individuals Covered210
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $4,519
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,877
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 number0523410000
Policy instance 7
Insurance contract or identification number0523410000
Number of Individuals Covered314
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of fees paid to insurance companyUSD $28,243
Welfare Benefit Premiums Paid to CarrierUSD $1,845,028
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 number0552250001
Policy instance 3
Insurance contract or identification number0552250001
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of fees paid to insurance companyUSD $10
Welfare Benefit Premiums Paid to CarrierUSD $620
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 number0523420000
Policy instance 5
Insurance contract or identification number0523420000
Number of Individuals Covered38
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of fees paid to insurance companyUSD $3,663
Welfare Benefit Premiums Paid to CarrierUSD $212,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082123
Policy instance 1
Insurance contract or identification number000010082123
Number of Individuals Covered236
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $5,670
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,921
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082122
Policy instance 2
Insurance contract or identification number000010082122
Number of Individuals Covered282
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $3,153
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,632
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0523410000
Policy instance 3
Insurance contract or identification number0523410000
Number of Individuals Covered297
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $27,994
Welfare Benefit Premiums Paid to CarrierUSD $1,723,390
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0523420001
Policy instance 4
Insurance contract or identification number0523420001
Number of Individuals Covered1
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $40
Welfare Benefit Premiums Paid to CarrierUSD $3,155
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0523420000
Policy instance 5
Insurance contract or identification number0523420000
Number of Individuals Covered87
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $7,746
Welfare Benefit Premiums Paid to CarrierUSD $476,433
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0523410001
Policy instance 7
Insurance contract or identification number0523410001
Number of Individuals Covered5
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $317
Welfare Benefit Premiums Paid to CarrierUSD $22,661
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0552250000
Policy instance 8
Insurance contract or identification number0552250000
Number of Individuals Covered3
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $322
Welfare Benefit Premiums Paid to CarrierUSD $21,016
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0552250001
Policy instance 9
Insurance contract or identification number0552250001
Number of Individuals Covered0
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number000382
Policy instance 6
Insurance contract or identification number000382
Number of Individuals Covered462
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $2,904
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,514
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082123
Policy instance 7
Insurance contract or identification number000010082123
Number of Individuals Covered228
Insurance policy start date2007-08-01
Insurance policy end date2008-07-31
Total amount of commissions paid to insurance brokerUSD $6,616
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,424
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 5
Insurance contract or identification number4953177
Number of Individuals Covered453
Insurance policy start date2007-08-01
Insurance policy end date2008-07-31
Total amount of commissions paid to insurance brokerUSD $10,734
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $161,040
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0523420001
Policy instance 4
Insurance contract or identification number0523420001
Number of Individuals Covered0
Insurance policy start date2007-08-01
Insurance policy end date2008-07-31
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0523410001
Policy instance 3
Insurance contract or identification number0523410001
Number of Individuals Covered2
Insurance policy start date2007-08-01
Insurance policy end date2008-07-31
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0523420000
Policy instance 2
Insurance contract or identification number0523420000
Number of Individuals Covered79
Insurance policy start date2007-08-01
Insurance policy end date2008-07-31
Total amount of commissions paid to insurance brokerUSD $11,192
Welfare Benefit Premiums Paid to CarrierUSD $370,739
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0523410000
Policy instance 1
Insurance contract or identification number0523410000
Number of Individuals Covered300
Insurance policy start date2007-08-01
Insurance policy end date2008-07-31
Total amount of commissions paid to insurance brokerUSD $39,802
Welfare Benefit Premiums Paid to CarrierUSD $1,329,847
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082122
Policy instance 6
Insurance contract or identification number000010082122
Number of Individuals Covered271
Insurance policy start date2007-08-01
Insurance policy end date2008-07-31
Total amount of commissions paid to insurance brokerUSD $3,377
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,586
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082122
Policy instance 2
Insurance contract or identification number000010082122
Number of Individuals Covered245
Insurance policy start date2006-08-01
Insurance policy end date2007-07-31
Total amount of commissions paid to insurance brokerUSD $2,142
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,678
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 5
Insurance contract or identification number4953177
Number of Individuals Covered387
Insurance policy start date2006-08-01
Insurance policy end date2007-07-31
Total amount of commissions paid to insurance brokerUSD $10,207
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $135,346
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 1
Insurance contract or identification number4953177
Number of Individuals Covered269
Insurance policy start date2006-08-01
Insurance policy end date2007-07-31
Total amount of commissions paid to insurance brokerUSD $41,996
Welfare Benefit Premiums Paid to CarrierUSD $1,227,985
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 4
Insurance contract or identification number4953177
Number of Individuals Covered70
Insurance policy start date2006-08-01
Insurance policy end date2007-07-31
Total amount of commissions paid to insurance brokerUSD $11,509
Welfare Benefit Premiums Paid to CarrierUSD $355,361
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010082123
Policy instance 3
Insurance contract or identification number000010082123
Number of Individuals Covered205
Insurance policy start date2006-08-01
Insurance policy end date2007-07-31
Total amount of commissions paid to insurance brokerUSD $4,263
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,695
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 5
Insurance contract or identification number4953177
Number of Individuals Covered201
Insurance policy start date2005-08-01
Insurance policy end date2006-07-31
Total amount of commissions paid to insurance brokerUSD $33,026
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number520067
Policy instance 3
Insurance contract or identification number520067
Number of Individuals Covered213
Insurance policy start date2005-08-01
Insurance policy end date2006-08-01
Total amount of commissions paid to insurance brokerUSD $1,810
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,889
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number580473
Policy instance 2
Insurance contract or identification number580473
Number of Individuals Covered182
Insurance policy start date2005-08-01
Insurance policy end date2006-08-01
Total amount of commissions paid to insurance brokerUSD $4,591
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,495
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 1
Insurance contract or identification number4953177
Number of Individuals Covered310
Insurance policy start date2005-08-01
Insurance policy end date2006-07-31
Total amount of commissions paid to insurance brokerUSD $9,599
Dental Insurance Welfare BenefitYes
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 4
Insurance contract or identification number4953177
Number of Individuals Covered76
Insurance policy start date2005-08-01
Insurance policy end date2006-07-31
Total amount of commissions paid to insurance brokerUSD $12,513
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 1
Insurance contract or identification number4953177
Number of Individuals Covered172
Insurance policy start date2004-08-01
Insurance policy end date2005-07-31
Total amount of commissions paid to insurance brokerUSD $25,350
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 2
Insurance contract or identification number4953177
Number of Individuals Covered79
Insurance policy start date2004-08-01
Insurance policy end date2005-07-31
Total amount of commissions paid to insurance brokerUSD $10,202
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number520067
Policy instance 4
Insurance contract or identification number520067
Number of Individuals Covered197
Insurance policy start date2004-08-01
Insurance policy end date2005-08-01
Total amount of commissions paid to insurance brokerUSD $1,846
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,224
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number580473
Policy instance 5
Insurance contract or identification number580473
Number of Individuals Covered169
Insurance policy start date2004-08-01
Insurance policy end date2005-08-01
Total amount of commissions paid to insurance brokerUSD $4,644
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,222
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4953177
Policy instance 3
Insurance contract or identification number4953177
Number of Individuals Covered279
Insurance policy start date2004-08-01
Insurance policy end date2005-07-31
Total amount of commissions paid to insurance brokerUSD $11,021
Dental Insurance Welfare BenefitYes

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