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BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 401k Plan overview

Plan NameBOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN
Plan identification number 503

BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES has sponsored the creation of one or more 401k plans.

Company Name:BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES
Employer identification number (EIN):133494848
NAIC Classification:561210
NAIC Description:Facilities Support Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01DAVID BLAUM2023-02-22
5032021-01-01DAVID BLAUM2022-07-21
5032020-01-01DAVID BLAUM2021-02-25
5032019-01-01DAVID BLAUM2020-03-18
5032018-01-01
5032017-01-01
5032016-01-01
5032015-01-01
5032014-01-01DAVID BLAUM
5032013-01-01DAVID BLAUM
5032012-10-01
5032011-10-01
5032010-10-01
5032010-07-01
5032009-07-01
5032009-01-01
5032008-01-01
5032007-01-01

Plan Statistics for BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN

401k plan membership statisitcs for BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN

Measure Date Value
2022: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01286
Total number of active participants reported on line 7a of the Form 55002022-01-01286
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01286
Number of employers contributing to the scheme2022-01-010
2021: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01286
Total number of active participants reported on line 7a of the Form 55002021-01-01286
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01286
Number of employers contributing to the scheme2021-01-010
2020: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01286
Total number of active participants reported on line 7a of the Form 55002020-01-01286
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01286
Number of employers contributing to the scheme2020-01-010
2019: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01286
Total number of active participants reported on line 7a of the Form 55002019-01-01286
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 participants2019-01-01286
Number of employers contributing to the scheme2019-01-010
2018: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01286
Total number of active participants reported on line 7a of the Form 55002018-01-01286
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01286
Number of employers contributing to the scheme2018-01-010
2017: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01286
Total number of active participants reported on line 7a of the Form 55002017-01-01286
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01286
2016: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01286
Total number of active participants reported on line 7a of the Form 55002016-01-01286
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01286
2015: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01308
Total number of active participants reported on line 7a of the Form 55002015-01-01286
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01286
2014: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01315
Total number of active participants reported on line 7a of the Form 55002014-01-01308
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01308
2013: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01287
Total number of active participants reported on line 7a of the Form 55002013-01-01315
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01315
2012: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01287
Total number of active participants reported on line 7a of the Form 55002012-10-01287
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01287
2011: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01287
Total number of active participants reported on line 7a of the Form 55002011-10-01287
Number of retired or separated participants receiving benefits2011-10-010
Number of other retired or separated participants entitled to future benefits2011-10-010
Total of all active and inactive participants2011-10-01287
2010: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-01484
Total number of active participants reported on line 7a of the Form 55002010-10-01287
Number of retired or separated participants receiving benefits2010-10-010
Number of other retired or separated participants entitled to future benefits2010-10-010
Total of all active and inactive participants2010-10-01287
Total participants, beginning-of-year2010-07-01484
Total number of active participants reported on line 7a of the Form 55002010-07-01484
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01484
2009: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01504
Total number of active participants reported on line 7a of the Form 55002009-07-01484
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01484
Total participants, beginning-of-year2009-01-01543
Total number of active participants reported on line 7a of the Form 55002009-01-01504
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01504
2008: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01543
Total number of active participants reported on line 7a of the Form 55002008-01-01543
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-010
Total of all active and inactive participants2008-01-01543
2007: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01100
Total number of active participants reported on line 7a of the Form 55002007-01-01543
Number of retired or separated participants receiving benefits2007-01-010
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-01543

Form 5500 Responses for BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN

2022: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle 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 planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle 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 planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle 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 planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2010: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planNo
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: BOSTON CONCESSIONS GROUP OF NY, LTD DBA CAMBRIDGE CORPORATE SERVICES - LIFE, ADD & LTD PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01First time form 5500 has been submittedYes
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYK960307
Policy instance 1
Insurance contract or identification numberNYK960307
Number of Individuals Covered286
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,767
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $77,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,767
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYK960307
Policy instance 1
Insurance contract or identification numberNYK960307
Number of Individuals Covered286
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,420
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $64,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,420
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYK960307
Policy instance 1
Insurance contract or identification numberNYK960307
Number of Individuals Covered286
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,244
Total amount of fees paid to insurance companyUSD $1,478
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $42,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,244
Amount paid for insurance broker fees1478
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYK960307
Policy instance 1
Insurance contract or identification numberNYK960307
Number of Individuals Covered286
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,758
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $67,577
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,758
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYK960307
Policy instance 1
Insurance contract or identification numberNYK960307
Number of Individuals Covered286
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,142
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $81,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $8,142
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY960446
Policy instance 1
Insurance contract or identification numberFLY960446
Number of Individuals Covered286
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,722
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 BenefitYes
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 $67,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,722
Insurance broker organization code?3
Insurance broker nameGDC FINANCIAL GROUP, INC.

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