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SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 401k Plan overview

Plan NameSUNBURY GENERATION, LP HEALTH INSURANCE PLAN
Plan identification number 502

SUNBURY GENERATION, LP HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

SUNBURY GENERATION,LP has sponsored the creation of one or more 401k plans.

Company Name:SUNBURY GENERATION,LP
Employer identification number (EIN):391964612
NAIC Classification:221100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SUNBURY GENERATION, LP HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022016-01-01
5022015-01-01
5022014-01-01MARIE MCCOMBS MARIE MCCOMBS2015-10-15
5022013-01-01MARIE MCCOMBS MARIE MCOMBS2014-10-13
5022012-01-01CLYDE M. PALMER MARIE L. MCCOMBS2013-10-16
5022011-01-01CLYDE M. PALMER MARIE L. MCCOMBS2012-10-15
5022010-01-01CLYDE M. PALMER MARIE L. MCCOMBS2011-10-14
5022009-01-01CLYDE M. PALMER, ADMINISTRATOR MARIE L. MCCOMBS, TREASURER2010-10-13

Plan Statistics for SUNBURY GENERATION, LP HEALTH INSURANCE PLAN

401k plan membership statisitcs for SUNBURY GENERATION, LP HEALTH INSURANCE PLAN

Measure Date Value
2016: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0111
Total number of active participants reported on line 7a of the Form 55002016-01-012
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-013
2015: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0158
Total number of active participants reported on line 7a of the Form 55002015-01-0111
Number of retired or separated participants receiving benefits2015-01-011
Total of all active and inactive participants2015-01-0112
2014: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0195
Total number of active participants reported on line 7a of the Form 55002014-01-0135
Number of retired or separated participants receiving benefits2014-01-0123
Total of all active and inactive participants2014-01-0158
2013: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01114
Total number of active participants reported on line 7a of the Form 55002013-01-0162
Number of retired or separated participants receiving benefits2013-01-0133
Total of all active and inactive participants2013-01-0195
2012: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01121
Total number of active participants reported on line 7a of the Form 55002012-01-0192
Number of retired or separated participants receiving benefits2012-01-0122
Total of all active and inactive participants2012-01-01114
2011: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01131
Total number of active participants reported on line 7a of the Form 55002011-01-0198
Number of retired or separated participants receiving benefits2011-01-0123
Total of all active and inactive participants2011-01-01121
2010: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01141
Total number of active participants reported on line 7a of the Form 55002010-01-01121
Number of retired or separated participants receiving benefits2010-01-0110
Total of all active and inactive participants2010-01-01131
2009: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01145
Total number of active participants reported on line 7a of the Form 55002009-01-01130
Number of retired or separated participants receiving benefits2009-01-0111
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01141

Form 5500 Responses for SUNBURY GENERATION, LP HEALTH INSURANCE PLAN

2016: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01This submission is the final filingYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: SUNBURY GENERATION, LP HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number850904099
Policy instance 2
Insurance contract or identification number850904099
Number of Individuals Covered61
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $623
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $623
Insurance broker nameTENTH DOT BENEFIT SOLUTIONS
GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )
Policy contract number107153
Policy instance 1
Insurance contract or identification number107153
Number of Individuals Covered46
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,357
Total amount of fees paid to insurance companyUSD $18
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,357
Amount paid for insurance broker fees18
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?4
Insurance broker nameTENTH DOT BENEFIT SOLUTIONS
GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )
Policy contract number107153
Policy instance 1
Insurance contract or identification number107153
Number of Individuals Covered330
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $51,577
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,930
Insurance broker organization code?3
Insurance broker nameTENTH DOT BENEFIT SOLUTIONS
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number850904099
Policy instance 2
Insurance contract or identification number850904099
Number of Individuals Covered220
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,627
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,627
Insurance broker organization code?3
Insurance broker nameM&T INSURANCE AGENCY
GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )
Policy contract number107153
Policy instance 1
Insurance contract or identification number107153
Number of Individuals Covered217
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $46,314
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,314
Insurance broker organization code?3
Insurance broker nameS&T- EVERGREEN INS ASSC LLC
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number850904099
Policy instance 2
Insurance contract or identification number850904099
Number of Individuals Covered259
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,290
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,290
Insurance broker organization code?3
Insurance broker nameM&T INSURANCE AGENCY
GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )
Policy contract number107153
Policy instance 1
Insurance contract or identification number107153
Number of Individuals Covered261
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $50,609
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,177
Insurance broker organization code?3
Insurance broker nameS&T- EVERGREEN INS ASSC LLC
GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )
Policy contract number107153
Policy instance 1
Insurance contract or identification number107153
Number of Individuals Covered116
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $50,889
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number01569911
Policy instance 2
Insurance contract or identification number01569911
Number of Individuals Covered120
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $776
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number850904-000
Policy instance 3
Insurance contract or identification number850904-000
Number of Individuals Covered126
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,982
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $84,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )
Policy contract number107153
Policy instance 1
Insurance contract or identification number107153
Number of Individuals Covered119
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $49,626
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,626
Additional information about fees paid to insurance brokerADMIN
Insurance broker organization code?3
Insurance broker nameS&T- EVERGREEN INS ASSC LLC
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number01569911
Policy instance 2
Insurance contract or identification number01569911
Number of Individuals Covered131
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $856
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $856
Insurance broker organization code?3
Insurance broker nameBROAD STREET BROKERAGE INSURANCE AG

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