ULS OF NEW ENGLAND LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ULS OF NEW ENGLAND HEALTH PLAN
| Measure | Date | Value |
|---|
| 2020: ULS OF NEW ENGLAND HEALTH PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 146 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 0 |
| 2019: ULS OF NEW ENGLAND HEALTH PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 146 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 146 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0AFMI |
| Policy instance | 1 |
| Insurance contract or identification number | GLUG0AFMI | | Number of Individuals Covered | 6 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2021-05-01 | | Total amount of commissions paid to insurance broker | USD $13 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $131 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 8032199 |
| Policy instance | 2 |
| Insurance contract or identification number | 8032199 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $11,588 | | Total amount of fees paid to insurance company | USD $1,275 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $379,294 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,588 | | Amount paid for insurance broker fees | 1275 | | Additional information about fees paid to insurance broker | BONUS AND/OR PERSISTENCY COMMISSIONS | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GUPM0AFMI |
| Policy instance | 3 |
| Insurance contract or identification number | GUPM0AFMI | | Number of Individuals Covered | 6 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2021-05-01 | | Total amount of commissions paid to insurance broker | USD $73 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $73 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 8032199 |
| Policy instance | 4 |
| Insurance contract or identification number | 8032199 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $3,968 | | Total amount of fees paid to insurance company | USD $1,350 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $119,434 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,968 | | Amount paid for insurance broker fees | 1350 | | Additional information about fees paid to insurance broker | BONUS AND/OR PERSISTENCY COMMISSIONS | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AFMI |
| Policy instance | 1 |
| Insurance contract or identification number | G000AFMI | | Number of Individuals Covered | 146 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-03-01 | | Total amount of commissions paid to insurance broker | USD $373 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,726 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $373 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 8032199 |
| Policy instance | 2 |
| Insurance contract or identification number | 8032199 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $9,184 | | Total amount of fees paid to insurance company | USD $1,560 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $332,644 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,184 | | Amount paid for insurance broker fees | 1560 | | Additional information about fees paid to insurance broker | BONUS AND/OR PERSISTENCY COMMISSIONS | | Insurance broker organization code? | 3 |
|
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