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GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameGRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN
Plan identification number 501

GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

GRAND STREET SETTLEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name:GRAND STREET SETTLEMENT, INC.
Employer identification number (EIN):135562230
NAIC Classification:624100
NAIC Description: Individual and Family Services

Additional information about GRAND STREET SETTLEMENT, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1940-12-21
Company Identification Number: 41764
Legal Registered Office Address: 80 PITT STREET
New York
NEW YORK
United States of America (USA)
10002

More information about GRAND STREET SETTLEMENT, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-12-01MARIA C. DEJESUS2024-03-18
5012021-12-01MARIA C. DEJESUS2023-08-02
5012020-12-01MARIA C. DEJESUS2022-06-16
5012019-12-01MARIA DEJESUS2021-04-21
5012018-12-01MARIA DEJESUS2020-06-25
5012017-12-01MARIA DEJESUS2019-04-23
5012011-12-01MARIA C DEJESUS
5012009-12-01MARGARITA ROSA

Plan Statistics for GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2022: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-12-01128
Total number of active participants reported on line 7a of the Form 55002022-12-01120
Number of retired or separated participants receiving benefits2022-12-010
Number of other retired or separated participants entitled to future benefits2022-12-010
Total of all active and inactive participants2022-12-01120
Number of employers contributing to the scheme2022-12-010
2021: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-01132
Total number of active participants reported on line 7a of the Form 55002021-12-01128
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-01128
Number of employers contributing to the scheme2021-12-010
2020: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01123
Total number of active participants reported on line 7a of the Form 55002020-12-01132
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-01132
Number of employers contributing to the scheme2020-12-010
2019: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01113
Total number of active participants reported on line 7a of the Form 55002019-12-01123
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01123
Number of employers contributing to the scheme2019-12-010
2018: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-01181
Total number of active participants reported on line 7a of the Form 55002018-12-01113
Number of retired or separated participants receiving benefits2018-12-010
Number of other retired or separated participants entitled to future benefits2018-12-010
Total of all active and inactive participants2018-12-01113
Number of employers contributing to the scheme2018-12-010
2017: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-01181
Total number of active participants reported on line 7a of the Form 55002017-12-01181
Number of retired or separated participants receiving benefits2017-12-010
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-01181
Number of employers contributing to the scheme2017-12-010
2011: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-12-0196
Total number of active participants reported on line 7a of the Form 55002011-12-0177
Number of retired or separated participants receiving benefits2011-12-010
Number of other retired or separated participants entitled to future benefits2011-12-010
Total of all active and inactive participants2011-12-0177
2009: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-12-01134
Total number of active participants reported on line 7a of the Form 55002009-12-01100
Number of retired or separated participants receiving benefits2009-12-010
Number of other retired or separated participants entitled to future benefits2009-12-010
Total of all active and inactive participants2009-12-01100

Form 5500 Responses for GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN

2022: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-12-01Type of plan entitySingle employer plan
2022-12-01Plan funding arrangement – InsuranceYes
2022-12-01Plan funding arrangement – General assets of the sponsorYes
2022-12-01Plan benefit arrangement – InsuranceYes
2022-12-01Plan benefit arrangement – General assets of the sponsorYes
2021: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – General assets of the sponsorYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – General assets of the sponsorYes
2020: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan funding arrangement – General assets of the sponsorYes
2020-12-01Plan benefit arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – General assets of the sponsorYes
2019: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan funding arrangement – General assets of the sponsorYes
2019-12-01Plan benefit arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – General assets of the sponsorYes
2018: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan funding arrangement – General assets of the sponsorYes
2018-12-01Plan benefit arrangement – InsuranceYes
2018-12-01Plan benefit arrangement – General assets of the sponsorYes
2017: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan funding arrangement – General assets of the sponsorYes
2017-12-01Plan benefit arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – General assets of the sponsorYes
2011: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-12-01Type of plan entitySingle employer plan
2011-12-01Submission has been amendedNo
2011-12-01This submission is the final filingNo
2011-12-01This return/report is a short plan year return/report (less than 12 months)No
2011-12-01Plan is a collectively bargained planNo
2011-12-01Plan funding arrangement – InsuranceYes
2011-12-01Plan funding arrangement – General assets of the sponsorYes
2011-12-01Plan benefit arrangement – InsuranceYes
2011-12-01Plan benefit arrangement – General assets of the sponsorYes
2009: GRAND STREET SETTLEMENT, INC. HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-12-01Type of plan entitySingle employer plan
2009-12-01Submission has been amendedNo
2009-12-01This submission is the final filingNo
2009-12-01This return/report is a short plan year return/report (less than 12 months)No
2009-12-01Plan is a collectively bargained planNo
2009-12-01Plan funding arrangement – InsuranceYes
2009-12-01Plan funding arrangement – General assets of the sponsorYes
2009-12-01Plan benefit arrangement – InsuranceYes
2009-12-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberSGN0600630
Policy instance 2
Insurance contract or identification numberSGN0600630
Number of Individuals Covered120
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $3,415
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 $29,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $3,415
Amount paid for insurance broker fees0
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number721284
Policy instance 1
Insurance contract or identification number721284
Number of Individuals Covered205
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $79,910
Total amount of fees paid to insurance companyUSD $2,046
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,882,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $79,910
Amount paid for insurance broker fees2046
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberSGN600630
Policy instance 2
Insurance contract or identification numberSGN600630
Number of Individuals Covered128
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $2,243
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 $105,555
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,243
Amount paid for insurance broker fees0
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number721284
Policy instance 1
Insurance contract or identification number721284
Number of Individuals Covered212
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $81,587
Total amount of fees paid to insurance companyUSD $2,647
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,294,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,587
Amount paid for insurance broker fees2647
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberSGN600630
Policy instance 2
Insurance contract or identification numberSGN600630
Number of Individuals Covered132
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $1,689
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 $22,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,689
Amount paid for insurance broker fees0
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number721284
Policy instance 1
Insurance contract or identification number721284
Number of Individuals Covered204
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $76,824
Total amount of fees paid to insurance companyUSD $1,553
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,008,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $76,824
Amount paid for insurance broker fees1553
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberSGN600630
Policy instance 2
Insurance contract or identification numberSGN600630
Number of Individuals Covered123
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $2,006
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 $15,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,006
Amount paid for insurance broker fees0
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number721284
Policy instance 1
Insurance contract or identification number721284
Number of Individuals Covered188
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $71,146
Total amount of fees paid to insurance companyUSD $2,578
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,843,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,146
Amount paid for insurance broker fees2578
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberSGN600630
Policy instance 2
Insurance contract or identification numberSGN600630
Number of Individuals Covered113
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $2,074
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 $15,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,074
Amount paid for insurance broker fees0
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number721284
Policy instance 1
Insurance contract or identification number721284
Number of Individuals Covered177
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $59,132
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,572,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59,132
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGN600630
Policy instance 2
Insurance contract or identification numberSGN600630
Number of Individuals Covered181
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $2,375
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 $19,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number721284
Policy instance 1
Insurance contract or identification number721284
Number of Individuals Covered147
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $91,650
Total amount of fees paid to insurance companyUSD $1,620
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,135,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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