401k Plan data: PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN plan

PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN
Plan identification number	501

PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability 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.

401k Sponsoring company profile

PENFIELD CHILDRENS CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: PENFIELD CHILDRENS CENTER, INC.

Employer identification number (EIN): 391093701

NAIC Classification: 624410
NAIC Description: Child Day Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-01-01
501 2015-01-01
501 2014-01-01

Plan Statistics for PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN

Measure Date Value
2015: PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 146
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 139
Total of all active and inactive participants 2015-01-01 139
2014: PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 146
Total of all active and inactive participants 2014-01-01 146

Measure	Date	Value
2015: PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	146
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	139
Total of all active and inactive participants	2015-01-01	139
2014: PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	146
Total of all active and inactive participants	2014-01-01	146

Form 5500 Responses for PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN

2015: PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: PENFIELD CHILDRENS CENTER, INC. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

169919

Policy instance

Insurance contract or identification number	169919
Number of Individuals Covered	139
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $19,657
Total amount of fees paid to insurance company	USD $2,254
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $832,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,657
Amount paid for insurance broker fees	2254
Additional information about fees paid to insurance broker	COMMISSIONS PAID BONUS AMOUNT
Insurance broker organization code?	3
Insurance broker name	INFINITY BENEFIT SOLUTIONS INC.

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

169919

Policy instance

Insurance contract or identification number	169919
Number of Individuals Covered	146
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $19,491
Total amount of fees paid to insurance company	USD $2,366
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $803,216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,491
Amount paid for insurance broker fees	2366
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	INFINITY BENEFIT SOLUTIONS INC.

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Company Name:	PENFIELD CHILDRENS CENTER, INC.
Employer identification number (EIN):	391093701
NAIC Classification:	624410
NAIC Description:	Child Day Care Services