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WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 401k Plan overview

Plan NameWORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND
Plan identification number 501

WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover
  • Collectively bargained welfare benefit arrangement under Code section 419A(f)(5).

401k Sponsoring company profile

WORCESTER PLUMBERS & PIPEFITTERS has sponsored the creation of one or more 401k plans.

Company Name:WORCESTER PLUMBERS & PIPEFITTERS
Employer identification number (EIN):046124621
NAIC Classification:813930
NAIC Description:Labor Unions and Similar Labor Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01MIRIAM ECHEVARRIA2023-10-16
5012021-01-01MIRIAM ECHEVARRIA2022-10-11
5012020-01-01MARK LAM2021-11-22
5012020-01-01MARK LAM2021-11-22
5012020-01-01MARK LAM2021-11-01
5012020-01-01MARK LAM2021-10-15
5012019-01-01TIMOTHY FERGUSON2020-10-14
5012018-01-01TIMOTHY FERGUSON2019-10-14
5012017-01-01
5012016-01-01
5012015-01-01TIMOTHY FERGUSON
5012014-01-01TRACY VAUGHAN
5012013-01-01TRACY VAUGHAN
5012012-01-01TRACY VAUGHAN
5012011-01-01TRACY VAUGHAN
5012010-01-01TRACY VAUGHAN
5012009-01-01TRACY VAUGHAN

Plan Statistics for WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND

401k plan membership statisitcs for WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND

Measure Date Value
2022: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2022 401k membership
Total participants, beginning-of-year2022-01-01378
Total number of active participants reported on line 7a of the Form 55002022-01-01258
Number of retired or separated participants receiving benefits2022-01-01122
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01380
Number of employers contributing to the scheme2022-01-0123
2021: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2021 401k membership
Total participants, beginning-of-year2021-01-01379
Total number of active participants reported on line 7a of the Form 55002021-01-01254
Number of retired or separated participants receiving benefits2021-01-01124
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01378
Number of employers contributing to the scheme2021-01-0119
2020: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2020 401k membership
Total participants, beginning-of-year2020-01-01379
Total number of active participants reported on line 7a of the Form 55002020-01-01245
Number of retired or separated participants receiving benefits2020-01-01134
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01379
2019: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2019 401k membership
Total participants, beginning-of-year2019-01-01390
Total number of active participants reported on line 7a of the Form 55002019-01-01379
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01379
Number of employers contributing to the scheme2019-01-0124
2018: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2018 401k membership
Total participants, beginning-of-year2018-01-01400
Total number of active participants reported on line 7a of the Form 55002018-01-01177
Number of retired or separated participants receiving benefits2018-01-0168
Number of other retired or separated participants entitled to future benefits2018-01-01145
Total of all active and inactive participants2018-01-01390
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-0112
2017: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2017 401k membership
Total participants, beginning-of-year2017-01-01401
Total number of active participants reported on line 7a of the Form 55002017-01-01167
Number of retired or separated participants receiving benefits2017-01-0164
Number of other retired or separated participants entitled to future benefits2017-01-01158
Total of all active and inactive participants2017-01-01389
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-0111
Total participants2017-01-01400
2016: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2016 401k membership
Total participants, beginning-of-year2016-01-01426
Total number of active participants reported on line 7a of the Form 55002016-01-01172
Number of retired or separated participants receiving benefits2016-01-0167
Number of other retired or separated participants entitled to future benefits2016-01-01150
Total of all active and inactive participants2016-01-01389
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
2015: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2015 401k membership
Total participants, beginning-of-year2015-01-01445
Total number of active participants reported on line 7a of the Form 55002015-01-01174
Number of retired or separated participants receiving benefits2015-01-0185
Number of other retired or separated participants entitled to future benefits2015-01-01167
Total of all active and inactive participants2015-01-01426
2014: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2014 401k membership
Total participants, beginning-of-year2014-01-01438
Total number of active participants reported on line 7a of the Form 55002014-01-01170
Number of retired or separated participants receiving benefits2014-01-0194
Number of other retired or separated participants entitled to future benefits2014-01-01181
Total of all active and inactive participants2014-01-01445
2013: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2013 401k membership
Total participants, beginning-of-year2013-01-01458
Total number of active participants reported on line 7a of the Form 55002013-01-01195
Number of retired or separated participants receiving benefits2013-01-0197
Number of other retired or separated participants entitled to future benefits2013-01-01146
Total of all active and inactive participants2013-01-01438
Total participants2013-01-010
Number of employers contributing to the scheme2013-01-010
2012: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2012 401k membership
Total participants, beginning-of-year2012-01-01493
Total number of active participants reported on line 7a of the Form 55002012-01-01214
Number of retired or separated participants receiving benefits2012-01-0172
Number of other retired or separated participants entitled to future benefits2012-01-01172
Total of all active and inactive participants2012-01-01458
Total participants2012-01-010
2011: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2011 401k membership
Total participants, beginning-of-year2011-01-01510
Total number of active participants reported on line 7a of the Form 55002011-01-01217
Number of retired or separated participants receiving benefits2011-01-0165
Number of other retired or separated participants entitled to future benefits2011-01-01210
Total of all active and inactive participants2011-01-01492
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-011
Total participants2011-01-01493
2010: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2010 401k membership
Total participants, beginning-of-year2010-01-01460
Total number of active participants reported on line 7a of the Form 55002010-01-01214
Number of retired or separated participants receiving benefits2010-01-01146
Number of other retired or separated participants entitled to future benefits2010-01-01150
Total of all active and inactive participants2010-01-01510
Total participants2010-01-01510
2009: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2009 401k membership
Total participants, beginning-of-year2009-01-01483
Total number of active participants reported on line 7a of the Form 55002009-01-01244
Number of retired or separated participants receiving benefits2009-01-01206
Number of other retired or separated participants entitled to future benefits2009-01-0110
Total of all active and inactive participants2009-01-01460
Total participants2009-01-01460

Financial Data on WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND

Measure Date Value
2022 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets2022-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$0
Total transfer of assets from this plan2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$60,999
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$69,338
Expenses. Interest paid2022-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022022-12-31$0
Total income from all sources (including contributions)2022-12-31$2,681,309
Total loss/gain on sale of assets2022-12-31$106,109
Total of all expenses incurred2022-12-31$4,081,177
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$3,961,710
Expenses. Certain deemed distributions of participant loans2022-12-31$0
Value of total corrective distributions2022-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$3,573,474
Value of total assets at end of year2022-12-31$9,810,289
Value of total assets at beginning of year2022-12-31$11,218,496
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$119,467
Total income from rents2022-12-31$0
Total interest from all sources2022-12-31$820
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$249,611
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$249,611
Administrative expenses professional fees incurred2022-12-31$52,532
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Amount of non-exempt transactions with any party-in-interest2022-12-31$0
Contributions received from participants2022-12-31$447,700
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$42,658
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$55,453
Other income not declared elsewhere2022-12-31$0
Administrative expenses (other) incurred2022-12-31$5,944
Liabilities. Value of operating payables at end of year2022-12-31$18,341
Liabilities. Value of operating payables at beginning of year2022-12-31$13,885
Total non interest bearing cash at end of year2022-12-31$454,380
Total non interest bearing cash at beginning of year2022-12-31$363,518
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-1,399,868
Value of net assets at end of year (total assets less liabilities)2022-12-31$9,749,290
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$11,149,158
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2022-12-31$0
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2022-12-31$0
Investment advisory and management fees2022-12-31$10,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$8,182,733
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$9,559,448
Interest on participant loans2022-12-31$0
Income. Interest from loans (other than to participants)2022-12-31$0
Interest earned on other investments2022-12-31$0
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$816,766
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$1,002,216
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$1,002,216
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$820
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$3,702,507
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,248,705
Net investment gain/loss from pooled separate accounts2022-12-31$0
Net investment gain or loss from common/collective trusts2022-12-31$0
Net gain/loss from 103.12 investment entities2022-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$3,125,774
Employer contributions (assets) at end of year2022-12-31$356,410
Employer contributions (assets) at beginning of year2022-12-31$293,314
Income. Dividends from preferred stock2022-12-31$0
Income. Dividends from common stock2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$259,203
Contract administrator fees2022-12-31$50,991
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$345,000
Aggregate carrying amount (costs) on sale of assets2022-12-31$238,891
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31NOVAK FRANCELLA, LLC
Accountancy firm EIN2022-12-31611436956
2021 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets2021-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$0
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets to this plan2021-12-31$0
Total transfer of assets from this plan2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$69,338
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$75,570
Expenses. Interest paid2021-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022021-12-31$0
Total income from all sources (including contributions)2021-12-31$4,382,354
Total loss/gain on sale of assets2021-12-31$76,006
Total of all expenses incurred2021-12-31$3,964,031
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$3,835,944
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Value of total corrective distributions2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$3,507,305
Value of total assets at end of year2021-12-31$11,218,496
Value of total assets at beginning of year2021-12-31$10,806,405
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$128,087
Total income from rents2021-12-31$0
Total interest from all sources2021-12-31$998
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$186,330
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$186,330
Administrative expenses professional fees incurred2021-12-31$55,842
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Amount of non-exempt transactions with any party-in-interest2021-12-31$0
Contributions received from participants2021-12-31$400,189
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$55,453
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$52,724
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$11,419
Liabilities. Value of operating payables at end of year2021-12-31$13,885
Liabilities. Value of operating payables at beginning of year2021-12-31$22,846
Total non interest bearing cash at end of year2021-12-31$363,518
Total non interest bearing cash at beginning of year2021-12-31$489,143
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Income. Non cash contributions2021-12-31$0
Value of net income/loss2021-12-31$418,323
Value of net assets at end of year (total assets less liabilities)2021-12-31$11,149,158
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$10,730,835
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2021-12-31$0
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2021-12-31$0
Investment advisory and management fees2021-12-31$10,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$9,559,448
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$9,456,579
Interest on participant loans2021-12-31$0
Income. Interest from loans (other than to participants)2021-12-31$0
Interest earned on other investments2021-12-31$0
Income. Interest from US Government securities2021-12-31$0
Income. Interest from corporate debt instruments2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$1,002,216
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$540,036
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$540,036
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$998
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$3,624,749
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$611,715
Net investment gain/loss from pooled separate accounts2021-12-31$0
Net investment gain or loss from common/collective trusts2021-12-31$0
Net gain/loss from 103.12 investment entities2021-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$3,107,116
Employer contributions (assets) at end of year2021-12-31$293,314
Employer contributions (assets) at beginning of year2021-12-31$320,647
Income. Dividends from preferred stock2021-12-31$0
Income. Dividends from common stock2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$211,195
Contract administrator fees2021-12-31$50,826
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$1,043,805
Aggregate carrying amount (costs) on sale of assets2021-12-31$967,799
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31NOVAK FRANCELLA, LLC
Accountancy firm EIN2021-12-31611436956
2020 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets2020-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$-2,580
Total unrealized appreciation/depreciation of assets2020-12-31$-2,580
Total transfer of assets to this plan2020-12-31$0
Total transfer of assets from this plan2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$75,570
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$4,185
Expenses. Interest paid2020-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022020-12-31$0
Total income from all sources (including contributions)2020-12-31$3,932,690
Total loss/gain on sale of assets2020-12-31$172,290
Total of all expenses incurred2020-12-31$4,050,099
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$3,930,200
Expenses. Certain deemed distributions of participant loans2020-12-31$0
Value of total corrective distributions2020-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,974,723
Value of total assets at end of year2020-12-31$10,806,405
Value of total assets at beginning of year2020-12-31$10,852,429
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$119,899
Total income from rents2020-12-31$0
Total interest from all sources2020-12-31$15,468
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$88,703
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$88,703
Administrative expenses professional fees incurred2020-12-31$54,056
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Amount of non-exempt transactions with any party-in-interest2020-12-31$0
Contributions received from participants2020-12-31$286,974
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$11,414
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$52,724
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$3,703
Other income not declared elsewhere2020-12-31$0
Administrative expenses (other) incurred2020-12-31$2,447
Liabilities. Value of operating payables at end of year2020-12-31$22,846
Liabilities. Value of operating payables at beginning of year2020-12-31$482
Total non interest bearing cash at end of year2020-12-31$489,143
Total non interest bearing cash at beginning of year2020-12-31$506,032
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Income. Non cash contributions2020-12-31$0
Value of net income/loss2020-12-31$-117,409
Value of net assets at end of year (total assets less liabilities)2020-12-31$10,730,835
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$10,848,244
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2020-12-31$0
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2020-12-31$0
Investment advisory and management fees2020-12-31$12,300
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$9,456,579
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$7,137,095
Interest on participant loans2020-12-31$0
Income. Interest from loans (other than to participants)2020-12-31$0
Interest earned on other investments2020-12-31$0
Income. Interest from US Government securities2020-12-31$9,578
Income. Interest from corporate debt instruments2020-12-31$5,841
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$540,036
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$811,259
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$811,259
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$49
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$3,647,995
Asset value of US Government securities at beginning of year2020-12-31$1,594,376
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$684,086
Net investment gain/loss from pooled separate accounts2020-12-31$0
Net investment gain or loss from common/collective trusts2020-12-31$0
Net gain/loss from 103.12 investment entities2020-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$2,687,749
Employer contributions (assets) at end of year2020-12-31$320,647
Employer contributions (assets) at beginning of year2020-12-31$345,449
Income. Dividends from preferred stock2020-12-31$0
Income. Dividends from common stock2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$282,205
Asset. Corporate debt instrument debt (other) at beginning of year2020-12-31$446,804
Contract administrator fees2020-12-31$51,096
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$5,213,868
Aggregate carrying amount (costs) on sale of assets2020-12-31$5,041,578
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31NOVAK FRANCELLA, LLC
Accountancy firm EIN2020-12-31611436956
2019 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$20,543
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$20,543
Total unrealized appreciation/depreciation of assets2019-12-31$20,543
Total unrealized appreciation/depreciation of assets2019-12-31$20,543
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$4,185
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$4,185
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$5,274,902
Total income from all sources (including contributions)2019-12-31$5,274,902
Total loss/gain on sale of assets2019-12-31$9,473
Total loss/gain on sale of assets2019-12-31$9,473
Total of all expenses incurred2019-12-31$4,025,134
Total of all expenses incurred2019-12-31$4,025,134
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,894,434
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,894,434
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$4,126,249
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$4,126,249
Value of total assets at end of year2019-12-31$10,852,429
Value of total assets at end of year2019-12-31$10,852,429
Value of total assets at beginning of year2019-12-31$9,598,476
Value of total assets at beginning of year2019-12-31$9,598,476
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$130,700
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$130,700
Total interest from all sources2019-12-31$55,189
Total interest from all sources2019-12-31$55,189
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$150,075
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$150,075
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$150,075
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$150,075
Administrative expenses professional fees incurred2019-12-31$63,995
Administrative expenses professional fees incurred2019-12-31$63,995
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$330,013
Contributions received from participants2019-12-31$330,013
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$11,414
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$11,414
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$8,983
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$8,983
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$3,703
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$3,703
Administrative expenses (other) incurred2019-12-31$60,036
Administrative expenses (other) incurred2019-12-31$60,036
Liabilities. Value of operating payables at end of year2019-12-31$482
Liabilities. Value of operating payables at end of year2019-12-31$482
Total non interest bearing cash at end of year2019-12-31$506,032
Total non interest bearing cash at end of year2019-12-31$506,032
Total non interest bearing cash at beginning of year2019-12-31$367,057
Total non interest bearing cash at beginning of year2019-12-31$367,057
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,249,768
Value of net income/loss2019-12-31$1,249,768
Value of net assets at end of year (total assets less liabilities)2019-12-31$10,848,244
Value of net assets at end of year (total assets less liabilities)2019-12-31$10,848,244
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$9,598,476
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$9,598,476
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$6,669
Investment advisory and management fees2019-12-31$6,669
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$7,137,095
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$7,137,095
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$6,373,648
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$6,373,648
Income. Interest from US Government securities2019-12-31$26,128
Income. Interest from US Government securities2019-12-31$26,128
Income. Interest from corporate debt instruments2019-12-31$10,650
Income. Interest from corporate debt instruments2019-12-31$10,650
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$811,259
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$811,259
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$18,411
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$18,411
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$3,599,493
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$3,599,493
Asset value of US Government securities at end of year2019-12-31$1,594,376
Asset value of US Government securities at end of year2019-12-31$1,594,376
Asset value of US Government securities at beginning of year2019-12-31$2,353,335
Asset value of US Government securities at beginning of year2019-12-31$2,353,335
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$913,373
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$913,373
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$3,796,236
Contributions received in cash from employer2019-12-31$3,796,236
Employer contributions (assets) at end of year2019-12-31$345,449
Employer contributions (assets) at end of year2019-12-31$345,449
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$294,941
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$294,941
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$446,804
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$446,804
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$495,453
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$495,453
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$2,127,281
Aggregate proceeds on sale of assets2019-12-31$2,127,281
Aggregate carrying amount (costs) on sale of assets2019-12-31$2,117,808
Aggregate carrying amount (costs) on sale of assets2019-12-31$2,117,808
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31NOVAK FRANCELLA LLC
Accountancy firm name2019-12-31NOVAK FRANCELLA LLC
Accountancy firm EIN2019-12-31611436956
Accountancy firm EIN2019-12-31611436956
2018 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-211,944
Total unrealized appreciation/depreciation of assets2018-12-31$-211,944
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$3,430,928
Total loss/gain on sale of assets2018-12-31$-298,043
Total of all expenses incurred2018-12-31$4,043,588
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$3,907,767
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$3,711,981
Value of total assets at end of year2018-12-31$9,598,476
Value of total assets at beginning of year2018-12-31$10,211,136
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$135,821
Total interest from all sources2018-12-31$80,339
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$148,595
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$58,904
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$373,814
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$108,575
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$8,983
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$40,318
Administrative expenses (other) incurred2018-12-31$60,871
Total non interest bearing cash at end of year2018-12-31$367,057
Total non interest bearing cash at beginning of year2018-12-31$450,117
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-612,660
Value of net assets at end of year (total assets less liabilities)2018-12-31$9,598,476
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$10,211,136
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$16,046
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$6,373,648
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,451,598
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$80,339
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$3,736,158
Asset value of US Government securities at end of year2018-12-31$2,353,335
Asset value of US Government securities at beginning of year2018-12-31$3,754,875
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$3,338,167
Income. Dividends from preferred stock2018-12-31$148,595
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$63,034
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$495,453
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$2,514,228
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$10,158,878
Aggregate carrying amount (costs) on sale of assets2018-12-31$10,456,921
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31GOULET, SALVIDIO & ASSOCIATES, PC
Accountancy firm EIN2018-12-31042623065
2017 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$533,415
Total unrealized appreciation/depreciation of assets2017-12-31$533,415
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$4,238,124
Total loss/gain on sale of assets2017-12-31$-28,987
Total of all expenses incurred2017-12-31$3,541,486
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$3,388,320
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$3,482,765
Value of total assets at end of year2017-12-31$10,211,136
Value of total assets at beginning of year2017-12-31$9,514,498
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$153,166
Total interest from all sources2017-12-31$190,092
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$60,839
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$58,563
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$382,516
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$44,965
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$40,318
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$40,006
Administrative expenses (other) incurred2017-12-31$60,066
Total non interest bearing cash at end of year2017-12-31$450,117
Total non interest bearing cash at beginning of year2017-12-31$284,302
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$696,638
Value of net assets at end of year (total assets less liabilities)2017-12-31$10,211,136
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$9,514,498
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$34,537
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$3,451,598
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,834,154
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$190,092
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$3,275,419
Asset value of US Government securities at end of year2017-12-31$3,754,875
Asset value of US Government securities at beginning of year2017-12-31$3,789,180
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$3,100,249
Income. Dividends from preferred stock2017-12-31$60,839
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$67,936
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$2,514,228
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$2,566,856
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$775,296
Aggregate carrying amount (costs) on sale of assets2017-12-31$804,283
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31GOULET, SALVIDIO & ASSOCIATES, PC
Accountancy firm EIN2017-12-31042623065
2016 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$272,487
Total unrealized appreciation/depreciation of assets2016-12-31$272,487
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$3,246,998
Total loss/gain on sale of assets2016-12-31$-95,927
Total of all expenses incurred2016-12-31$3,459,723
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,293,538
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,811,047
Value of total assets at end of year2016-12-31$9,514,498
Value of total assets at beginning of year2016-12-31$9,727,223
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$166,185
Total interest from all sources2016-12-31$202,927
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$56,464
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$68,837
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$309,297
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$25,971
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$40,006
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$43,873
Administrative expenses (other) incurred2016-12-31$61,371
Total non interest bearing cash at end of year2016-12-31$284,302
Total non interest bearing cash at beginning of year2016-12-31$317,002
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-212,725
Value of net assets at end of year (total assets less liabilities)2016-12-31$9,514,498
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$9,727,223
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$35,977
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,834,154
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,532,162
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$202,927
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$3,202,863
Asset value of US Government securities at end of year2016-12-31$3,789,180
Asset value of US Government securities at beginning of year2016-12-31$4,275,643
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$2,501,750
Income. Dividends from preferred stock2016-12-31$56,464
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$64,704
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$2,566,856
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$2,558,543
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$1,502,624
Aggregate carrying amount (costs) on sale of assets2016-12-31$1,598,551
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31GOULET, SALVIDIO & ASSOCIATES, PC
Accountancy firm EIN2016-12-31042623065
2015 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-95,120
Total unrealized appreciation/depreciation of assets2015-12-31$-95,120
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$3,854,922
Total loss/gain on sale of assets2015-12-31$-40,979
Total of all expenses incurred2015-12-31$3,353,839
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$3,204,530
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$3,729,438
Value of total assets at end of year2015-12-31$9,727,223
Value of total assets at beginning of year2015-12-31$9,226,140
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$149,309
Total interest from all sources2015-12-31$209,070
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$52,513
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$52,513
Administrative expenses professional fees incurred2015-12-31$64,175
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$259,233
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$102,578
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$43,873
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$42,733
Administrative expenses (other) incurred2015-12-31$49,540
Total non interest bearing cash at end of year2015-12-31$317,002
Total non interest bearing cash at beginning of year2015-12-31$415,808
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$501,083
Value of net assets at end of year (total assets less liabilities)2015-12-31$9,727,223
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$9,226,140
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$35,594
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,532,162
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,498,116
Income. Interest from US Government securities2015-12-31$209,070
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$3,024,062
Asset value of US Government securities at end of year2015-12-31$4,275,643
Asset value of US Government securities at beginning of year2015-12-31$3,868,394
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$3,470,205
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$77,890
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$2,558,543
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$2,401,089
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$1,261,978
Aggregate carrying amount (costs) on sale of assets2015-12-31$1,302,957
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31GOULET, SALVIDIO & ASSOCIATES, P.C.
Accountancy firm EIN2015-12-31042623065
2014 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$194,458
Total unrealized appreciation/depreciation of assets2014-12-31$194,458
Total income from all sources (including contributions)2014-12-31$3,530,098
Total loss/gain on sale of assets2014-12-31$68,296
Total of all expenses incurred2014-12-31$3,025,196
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$2,854,694
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$3,010,309
Value of total assets at end of year2014-12-31$9,226,140
Value of total assets at beginning of year2014-12-31$8,721,238
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$170,502
Total interest from all sources2014-12-31$211,350
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$45,685
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$45,685
Administrative expenses professional fees incurred2014-12-31$73,234
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$247,858
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$22,914
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$42,733
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$43,985
Administrative expenses (other) incurred2014-12-31$63,043
Total non interest bearing cash at end of year2014-12-31$415,808
Total non interest bearing cash at beginning of year2014-12-31$341,471
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$504,902
Value of net assets at end of year (total assets less liabilities)2014-12-31$9,226,140
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$8,721,238
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$34,225
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$2,498,116
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,198,120
Income. Interest from US Government securities2014-12-31$211,350
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$2,753,821
Asset value of US Government securities at end of year2014-12-31$3,868,394
Asset value of US Government securities at beginning of year2014-12-31$3,981,350
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$2,762,451
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$77,959
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$2,401,089
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$2,156,312
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$3,774,862
Aggregate carrying amount (costs) on sale of assets2014-12-31$3,706,566
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31GOULET, SALVIDIO & ASSOCIATES, P.C.
Accountancy firm EIN2014-12-31042623065
2013 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$256,173
Total unrealized appreciation/depreciation of assets2013-12-31$256,173
Total income from all sources (including contributions)2013-12-31$3,440,297
Total loss/gain on sale of assets2013-12-31$-27,964
Total of all expenses incurred2013-12-31$3,135,686
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$2,971,256
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$2,950,550
Value of total assets at end of year2013-12-31$8,721,238
Value of total assets at beginning of year2013-12-31$8,416,627
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$164,430
Total interest from all sources2013-12-31$221,621
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$39,917
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$39,917
Administrative expenses professional fees incurred2013-12-31$71,044
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$401,163
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$22,843
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$43,985
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$45,599
Administrative expenses (other) incurred2013-12-31$59,052
Total non interest bearing cash at end of year2013-12-31$341,471
Total non interest bearing cash at beginning of year2013-12-31$342,273
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$304,611
Value of net assets at end of year (total assets less liabilities)2013-12-31$8,721,238
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$8,416,627
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$34,334
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,198,120
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,661,148
Income. Interest from US Government securities2013-12-31$221,621
Value of interest in common/collective trusts at end of year2013-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$2,883,302
Asset value of US Government securities at end of year2013-12-31$3,981,350
Asset value of US Government securities at beginning of year2013-12-31$4,380,811
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$2,549,387
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$65,111
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$2,156,312
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$1,986,796
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$1,163,276
Aggregate carrying amount (costs) on sale of assets2013-12-31$1,191,240
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31GOULET, SALVIDIO & ASSOCIATES, PC
Accountancy firm EIN2013-12-31042623065
2012 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$219,785
Total unrealized appreciation/depreciation of assets2012-12-31$219,785
Total income from all sources (including contributions)2012-12-31$4,445,887
Total loss/gain on sale of assets2012-12-31$-50,067
Total of all expenses incurred2012-12-31$3,498,357
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$3,343,849
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$4,020,884
Value of total assets at end of year2012-12-31$8,416,627
Value of total assets at beginning of year2012-12-31$7,469,097
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$154,508
Total interest from all sources2012-12-31$219,666
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$35,619
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$35,619
Administrative expenses professional fees incurred2012-12-31$67,200
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$286,736
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$59,020
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$45,599
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$34,022
Administrative expenses (other) incurred2012-12-31$54,338
Total non interest bearing cash at end of year2012-12-31$342,273
Total non interest bearing cash at beginning of year2012-12-31$795,559
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$947,530
Value of net assets at end of year (total assets less liabilities)2012-12-31$8,416,627
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$7,469,097
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$32,970
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,661,148
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$1,432,341
Interest earned on other investments2012-12-31$124
Income. Interest from US Government securities2012-12-31$219,542
Value of interest in common/collective trusts at end of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$3,230,313
Asset value of US Government securities at end of year2012-12-31$4,380,811
Asset value of US Government securities at beginning of year2012-12-31$3,601,269
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$3,734,148
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$54,516
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$1,986,796
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$1,605,906
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$1,371,957
Aggregate carrying amount (costs) on sale of assets2012-12-31$1,422,024
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31GOULET, SALVIDIO & ASSOCIATES, PC
Accountancy firm EIN2012-12-31042623065
2011 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$248,875
Total unrealized appreciation/depreciation of assets2011-12-31$248,875
Total income from all sources (including contributions)2011-12-31$4,203,022
Total loss/gain on sale of assets2011-12-31$-14,240
Total of all expenses incurred2011-12-31$3,378,347
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$3,225,636
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$3,718,028
Value of total assets at end of year2011-12-31$7,469,097
Value of total assets at beginning of year2011-12-31$6,644,422
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$152,711
Total interest from all sources2011-12-31$234,695
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$15,664
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$15,664
Administrative expenses professional fees incurred2011-12-31$62,482
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$489,233
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$17,059
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$34,022
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$44,716
Administrative expenses (other) incurred2011-12-31$57,119
Total non interest bearing cash at end of year2011-12-31$795,559
Total non interest bearing cash at beginning of year2011-12-31$248,861
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$824,675
Value of net assets at end of year (total assets less liabilities)2011-12-31$7,469,097
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$6,644,422
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$33,110
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$1,432,341
Income. Interest from US Government securities2011-12-31$234,695
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$3,155,034
Asset value of US Government securities at end of year2011-12-31$3,601,269
Asset value of US Government securities at beginning of year2011-12-31$4,245,323
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$3,228,795
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$53,543
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$1,605,906
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$2,105,522
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$3,126,296
Aggregate carrying amount (costs) on sale of assets2011-12-31$3,140,536
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31GOULET, SALVIDIO & ASSOCIATES, PC
Accountancy firm EIN2011-12-31042623065
2010 : WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$96,943
Total unrealized appreciation/depreciation of assets2010-12-31$96,943
Total income from all sources (including contributions)2010-12-31$3,487,345
Total loss/gain on sale of assets2010-12-31$-44,876
Total of all expenses incurred2010-12-31$3,807,884
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$3,641,958
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$3,159,869
Value of total assets at end of year2010-12-31$6,644,422
Value of total assets at beginning of year2010-12-31$6,964,961
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$165,926
Total interest from all sources2010-12-31$275,409
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$87,406
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$421,716
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$504
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$33,253
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$44,716
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$62,041
Administrative expenses (other) incurred2010-12-31$51,398
Total non interest bearing cash at end of year2010-12-31$248,861
Total non interest bearing cash at beginning of year2010-12-31$294,251
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-320,539
Value of net assets at end of year (total assets less liabilities)2010-12-31$6,644,422
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$6,964,961
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31Yes
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2010-12-31$113,361
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$27,122
Income. Interest from US Government securities2010-12-31$275,409
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$3,552,798
Asset value of US Government securities at end of year2010-12-31$4,245,323
Asset value of US Government securities at beginning of year2010-12-31$4,205,000
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$2,738,153
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$55,907
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$2,105,522
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$2,403,165
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$2,801,407
Aggregate carrying amount (costs) on sale of assets2010-12-31$2,846,283
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31GOULET, SALVIDIO & ASSOCIATES, PC
Accountancy firm EIN2010-12-31042623065

Form 5500 Responses for WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND

2022: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2022 form 5500 responses
2022-01-01Type of plan entityMulti-employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2021 form 5500 responses
2021-01-01Type of plan entityMulti-employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2020 form 5500 responses
2020-01-01Type of plan entityMulti-employer plan
2020-01-01Submission has been amendedYes
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2018 form 5500 responses
2018-01-01Type of plan entityMulti-employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2013 form 5500 responses
2013-01-01Type of plan entityMulti-employer plan
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Submission has been amendedYes
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2010 form 5500 responses
2010-01-01Type of plan entityMulti-employer plan
2010-01-01Plan is a collectively bargained planYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: WORCESTER PLUMBERS & PIPEFITTERS HEALTH & WELFARE FUND 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 5
Insurance contract or identification number0004523
Number of Individuals Covered76
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $5,338
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEDICARE SUPPLEMENTAL
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 $176,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,338
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 4
Insurance contract or identification number50010941
Number of Individuals Covered262
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $933
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $5,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $933
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 3
Insurance contract or identification number50010941
Number of Individuals Covered382
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $5,556
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $32,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,556
Insurance broker organization code?3
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number1942
Policy instance 2
Insurance contract or identification number1942
Number of Individuals Covered26
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEDICARE SUPPLEMENTAL
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 $107,776
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 number0004523
Policy instance 1
Insurance contract or identification number0004523
Number of Individuals Covered418
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $49,339
Total amount of fees paid to insurance companyUSD $18,300
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,227,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,339
Amount paid for insurance broker fees18300
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 1
Insurance contract or identification number0004523
Number of Individuals Covered407
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $48,785
Total amount of fees paid to insurance companyUSD $15,359
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,170,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $48,785
Amount paid for insurance broker fees15359
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 3
Insurance contract or identification number50010941
Number of Individuals Covered376
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5,436
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $31,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,436
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 4
Insurance contract or identification number50010941
Number of Individuals Covered254
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $900
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $5,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $900
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 5
Insurance contract or identification number0004523
Number of Individuals Covered70
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,833
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEDICARE SUPPLEMENTAL
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 $308,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,833
Insurance broker organization code?3
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number1942
Policy instance 2
Insurance contract or identification number1942
Number of Individuals Covered27
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEDICARE SUPPLEMENTAL
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 $108,732
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 number0004523
Policy instance 1
Insurance contract or identification number0004523
Number of Individuals Covered184
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $61,328
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,258,068
Commission paid to Insurance BrokerUSD $61,328
Insurance broker organization code?3
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number1942
Policy instance 2
Insurance contract or identification number1942
Number of Individuals Covered27
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEDICARE SUPPLEMENTAL
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 $109,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 3
Insurance contract or identification number50010941
Number of Individuals Covered371
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,292
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $31,131
Commission paid to Insurance BrokerUSD $5,292
Insurance broker organization code?3
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 number0004523
Policy instance 5
Insurance contract or identification number0004523
Number of Individuals Covered64
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,614
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEDICARE SUPPLEMENTAL
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 $300,338
Commission paid to Insurance BrokerUSD $5,614
Insurance broker organization code?3
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 4
Insurance contract or identification number50010941
Number of Individuals Covered245
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,953
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $17,370
Commission paid to Insurance BrokerUSD $2,953
Insurance broker organization code?3
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 5
Insurance contract or identification number50010941
Number of Individuals Covered379
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,441
Total amount of fees paid to insurance companyUSD $625
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $32,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,441
Insurance broker organization code?3
Amount paid for insurance broker fees625
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number1942
Policy instance 4
Insurance contract or identification number1942
Number of Individuals Covered30
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $115,366
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 numberK70102138
Policy instance 3
Insurance contract or identification numberK70102138
Number of Individuals Covered66
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $154,033
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 number0004523
Policy instance 2
Insurance contract or identification number0004523
Number of Individuals Covered69
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,591
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,591
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 1
Insurance contract or identification number0004523
Number of Individuals Covered181
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $48,327
Total amount of fees paid to insurance companyUSD $17,950
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,327
Amount paid for insurance broker fees17950
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 6
Insurance contract or identification number50010941
Number of Individuals Covered240
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,926
Total amount of fees paid to insurance companyUSD $342
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $17,214
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,926
Insurance broker organization code?3
Amount paid for insurance broker fees342
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 1
Insurance contract or identification number0004523
Number of Individuals Covered185
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $47,849
Total amount of fees paid to insurance companyUSD $19,320
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,849
Amount paid for insurance broker fees19320
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 2
Insurance contract or identification number0004523
Number of Individuals Covered68
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,607
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,607
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract numberK70102138
Policy instance 3
Insurance contract or identification numberK70102138
Number of Individuals Covered185
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $131,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number1942
Policy instance 4
Insurance contract or identification number1942
Number of Individuals Covered32
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $126,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 5
Insurance contract or identification number50010941
Number of Individuals Covered384
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,640
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $33,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,640
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 6
Insurance contract or identification number50010941
Number of Individuals Covered253
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,098
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $18,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,098
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 1
Insurance contract or identification number0004523
Number of Individuals Covered182
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $43,504
Total amount of fees paid to insurance companyUSD $18,480
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,504
Amount paid for insurance broker fees18480
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY, LLC
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number1942
Policy instance 2
Insurance contract or identification number1942
Number of Individuals Covered30
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $108,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 3
Insurance contract or identification number50010941
Number of Individuals Covered389
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,590
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $32,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,590
Insurance broker organization code?3
Insurance broker nameINDIGO INSURANCE SERVICES
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 4
Insurance contract or identification number0004523
Number of Individuals Covered51
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,523
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,523
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY, LLC
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 5
Insurance contract or identification number50010941
Number of Individuals Covered257
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,066
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $18,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,066
Insurance broker organization code?3
Insurance broker nameINDIGO INSURANCE SERVICES
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002238625C02
Policy instance 6
Insurance contract or identification numberC002238625C02
Number of Individuals Covered13
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $56,189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00466109
Policy instance 7
Insurance contract or identification number00466109
Number of Individuals Covered209
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,945
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare 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 $5,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,945
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY, LLC
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract numberK70102138
Policy instance 8
Insurance contract or identification numberK70102138
Number of Individuals Covered182
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $104,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 8
Insurance contract or identification number50010941
Number of Individuals Covered290
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,057
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $17,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,057
Insurance broker organization code?3
Insurance broker nameINDIGO INSURANCE SERVICES
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 1
Insurance contract or identification number0004523
Number of Individuals Covered179
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $41,776
Total amount of fees paid to insurance companyUSD $19,910
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,776
Amount paid for insurance broker fees19910
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY, LLC
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 7
Insurance contract or identification number50010941
Number of Individuals Covered400
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,481
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $32,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,481
Insurance broker organization code?3
Insurance broker nameINDIGO INSURANCE SERVICES
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number1942
Policy instance 6
Insurance contract or identification number1942
Number of Individuals Covered31
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 $101,561
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00466109
Policy instance 5
Insurance contract or identification number00466109
Number of Individuals Covered219
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $7,904
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 $21,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,904
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY, LLC
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002238625C02
Policy instance 4
Insurance contract or identification numberC002238625C02
Number of Individuals Covered15
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 $56,977
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 numberK70102138
Policy instance 3
Insurance contract or identification numberK70102138
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $73,551
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 number0004523
Policy instance 2
Insurance contract or identification number0004523
Number of Individuals Covered52
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,998
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,998
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY, LLC
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberC002238625C01
Policy instance 8
Insurance contract or identification numberC002238625C01
Number of Individuals Covered18
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $641
Welfare Benefit Premiums Paid to CarrierUSD $21,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $641
Insurance broker nameMARSH & MCLENNAN
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002238625C01
Policy instance 7
Insurance contract or identification numberC002238625C01
Number of Individuals Covered330
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $10,643
Welfare Benefit Premiums Paid to CarrierUSD $352,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,643
Insurance broker nameMARSH & MCLENNAN LLC
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002238625C02
Policy instance 6
Insurance contract or identification numberC002238625C02
Number of Individuals Covered18
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Welfare Benefit Premiums Paid to CarrierUSD $59,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number462S2893801
Policy instance 4
Insurance contract or identification number462S2893801
Number of Individuals Covered47
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Welfare Benefit Premiums Paid to CarrierUSD $63,743
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 number0004523
Policy instance 3
Insurance contract or identification number0004523
Number of Individuals Covered454
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $59,818
Welfare Benefit Premiums Paid to CarrierUSD $1,920,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,570
Insurance broker nameBOSTONIAN GROUP
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 2
Insurance contract or identification number50010941
Number of Individuals Covered420
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,613
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,613
Insurance broker nameINDIGO INSURANCE SERVICES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00466109
Policy instance 1
Insurance contract or identification number00466109
Number of Individuals Covered209
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $7,565
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,565
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 9
Insurance contract or identification number50010941
Number of Individuals Covered297
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,077
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,077
Insurance broker nameINDIGO INSURANCE SERVICES
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number1942
Policy instance 5
Insurance contract or identification number1942
Number of Individuals Covered34
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,500
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,500
Insurance broker nameTHE PROTECTOR GROUP INSURANCE
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 2
Insurance contract or identification number0004523
Number of Individuals Covered135
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $27,204
Welfare Benefit Premiums Paid to CarrierUSD $763,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,204
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number2238625
Policy instance 3
Insurance contract or identification number2238625
Number of Individuals Covered19
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,719
Welfare Benefit Premiums Paid to CarrierUSD $120,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,719
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number462S2893801
Policy instance 4
Insurance contract or identification number462S2893801
Number of Individuals Covered43
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Welfare Benefit Premiums Paid to CarrierUSD $83,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00466109
Policy instance 6
Insurance contract or identification number00466109
Number of Individuals Covered217
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $7,711
Total amount of fees paid to insurance companyUSD $2,761
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,711
Amount paid for insurance broker fees2761
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number2238625
Policy instance 5
Insurance contract or identification number2238625
Number of Individuals Covered334
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $46,452
Welfare Benefit Premiums Paid to CarrierUSD $1,550,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,452
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 7
Insurance contract or identification number50010941
Number of Individuals Covered281
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,169
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,169
Insurance broker organization code?3
Insurance broker nameINDIGO INSURANCE SERVICES
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 8
Insurance contract or identification number50010941
Number of Individuals Covered280
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,861
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,861
Insurance broker organization code?3
Insurance broker nameINDIGO INSURANCE SERVICES
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number2238625C02
Policy instance 1
Insurance contract or identification number2238625C02
Number of Individuals Covered60
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Welfare Benefit Premiums Paid to CarrierUSD $172,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 7
Insurance contract or identification number0004523
Number of Individuals Covered157
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $21,728
Welfare Benefit Premiums Paid to CarrierUSD $847,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees21728
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number2238625C02
Policy instance 8
Insurance contract or identification number2238625C02
Number of Individuals Covered60
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Welfare Benefit Premiums Paid to CarrierUSD $207,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number2238625
Policy instance 6
Insurance contract or identification number2238625
Number of Individuals Covered17
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $1,158
Welfare Benefit Premiums Paid to CarrierUSD $104,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1158
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number462S2893801
Policy instance 5
Insurance contract or identification number462S2893801
Number of Individuals Covered40
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $4,270
Welfare Benefit Premiums Paid to CarrierUSD $92,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4270
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 1
Insurance contract or identification number50010941
Number of Individuals Covered314
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $2,762
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2762
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number2238625
Policy instance 4
Insurance contract or identification number2238625
Number of Individuals Covered403
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $50,133
Welfare Benefit Premiums Paid to CarrierUSD $1,747,187
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees50133
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00466109
Policy instance 3
Insurance contract or identification number00466109
Number of Individuals Covered246
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $12,756
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $239,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees12756
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50010941
Policy instance 2
Insurance contract or identification number50010941
Number of Individuals Covered453
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $4,775
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4775
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract numberG52516
Policy instance 8
Insurance contract or identification numberG52516
Number of Individuals Covered484
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of fees paid to insurance companyUSD $7,229
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number2238625
Policy instance 2
Insurance contract or identification number2238625
Number of Individuals Covered408
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Welfare Benefit Premiums Paid to CarrierUSD $1,777,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00466109
Policy instance 1
Insurance contract or identification number00466109
Number of Individuals Covered249
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $13,161
Welfare Benefit Premiums Paid to CarrierUSD $158,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number462S2893801
Policy instance 3
Insurance contract or identification number462S2893801
Number of Individuals Covered37
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Welfare Benefit Premiums Paid to CarrierUSD $91,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5722683
Policy instance 4
Insurance contract or identification number5722683
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of fees paid to insurance companyUSD $551
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,699
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 number064796
Policy instance 9
Insurance contract or identification number064796
Insurance policy start date2011-01-01
Insurance policy end date2011-03-01
Welfare Benefit Premiums Paid to CarrierUSD $221,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number2238625
Policy instance 5
Insurance contract or identification number2238625
Number of Individuals Covered9
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of fees paid to insurance companyUSD $54,659
Welfare Benefit Premiums Paid to CarrierUSD $79,662
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 number0004523
Policy instance 6
Insurance contract or identification number0004523
Number of Individuals Covered229
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of fees paid to insurance companyUSD $20,477
Welfare Benefit Premiums Paid to CarrierUSD $643,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number2238625
Policy instance 7
Insurance contract or identification number2238625
Number of Individuals Covered64
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Welfare Benefit Premiums Paid to CarrierUSD $174,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number2238625
Policy instance 1
Insurance contract or identification number2238625
Number of Individuals Covered66
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Welfare Benefit Premiums Paid to CarrierUSD $164,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number462S2893801
Policy instance 2
Insurance contract or identification number462S2893801
Number of Individuals Covered36
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Welfare Benefit Premiums Paid to CarrierUSD $87,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number2238625
Policy instance 4
Insurance contract or identification number2238625
Number of Individuals Covered9
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $1,215
Welfare Benefit Premiums Paid to CarrierUSD $82,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1215
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5722683
Policy instance 3
Insurance contract or identification number5722683
Number of Individuals Covered453
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of fees paid to insurance companyUSD $1,573
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $238,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1573
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0004523
Policy instance 5
Insurance contract or identification number0004523
Number of Individuals Covered36
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $3,759
Welfare Benefit Premiums Paid to CarrierUSD $83,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3759
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number2238625
Policy instance 6
Insurance contract or identification number2238625
Number of Individuals Covered404
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $52,062
Welfare Benefit Premiums Paid to CarrierUSD $1,945,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees52062
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract numberG52516
Policy instance 7
Insurance contract or identification numberG52516
Number of Individuals Covered510
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $6,138
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,945,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6138
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number064796
Policy instance 8
Insurance contract or identification number064796
Number of Individuals Covered168
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $25,273
Welfare Benefit Premiums Paid to CarrierUSD $1,094,554
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees25273
Insurance broker organization code?3
Insurance broker namePROTECTOR GROUP

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