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THE ALFRED AND ADELE DAVIS ACADEMY, INC. 401k Plan overview

Plan NameTHE ALFRED AND ADELE DAVIS ACADEMY, INC.
Plan identification number 502

THE ALFRED AND ADELE DAVIS ACADEMY, INC. Benefits

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

401k Sponsoring company profile

THE ALFRED AND ADELE DAVIS ACADEMY ,INC. has sponsored the creation of one or more 401k plans.

Company Name:THE ALFRED AND ADELE DAVIS ACADEMY ,INC.
Employer identification number (EIN):581970181
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE ALFRED AND ADELE DAVIS ACADEMY, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022020-07-01
5022019-07-01
5022019-05-01
5022019-05-01
5022018-05-01
5022018-05-01
5022017-05-01BONNIE VAVRA
5022016-05-01BONNIE VAVRA

Plan Statistics for THE ALFRED AND ADELE DAVIS ACADEMY, INC.

401k plan membership statisitcs for THE ALFRED AND ADELE DAVIS ACADEMY, INC.

Measure Date Value
2020: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2020 401k membership
Total participants, beginning-of-year2020-07-01144
Total number of active participants reported on line 7a of the Form 55002020-07-01189
Total of all active and inactive participants2020-07-01189
Total participants2020-07-01189
2019: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2019 401k membership
Total participants, beginning-of-year2019-07-01107
Total number of active participants reported on line 7a of the Form 55002019-07-01144
Total of all active and inactive participants2019-07-01144
Total participants2019-07-01144
Total participants, beginning-of-year2019-05-01104
Total number of active participants reported on line 7a of the Form 55002019-05-01107
Total of all active and inactive participants2019-05-01107
Total participants2019-05-01107
2018: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2018 401k membership
Total participants, beginning-of-year2018-05-01122
Total number of active participants reported on line 7a of the Form 55002018-05-01104
Total of all active and inactive participants2018-05-01104
Total participants2018-05-01104
2017: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2017 401k membership
Total participants, beginning-of-year2017-05-01127
Total number of active participants reported on line 7a of the Form 55002017-05-01122
Total of all active and inactive participants2017-05-01122
Total participants2017-05-01122
2016: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2016 401k membership
Total participants, beginning-of-year2016-05-010
Total number of active participants reported on line 7a of the Form 55002016-05-01127
Total of all active and inactive participants2016-05-01127
Total participants2016-05-01127

Form 5500 Responses for THE ALFRED AND ADELE DAVIS ACADEMY, INC.

2020: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedYes
2019-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedYes
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: THE ALFRED AND ADELE DAVIS ACADEMY, INC. 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01First time form 5500 has been submittedYes
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number839397
Policy instance 1
Insurance contract or identification number839397
Number of Individuals Covered118
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $7,183
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,183
Insurance broker organization code?3
HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. (National Association of Insurance Commissioners NAIC id number: 95519 )
Policy contract number839397
Policy instance 2
Insurance contract or identification number839397
Number of Individuals Covered71
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $42,531
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $787,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,531
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0918365
Policy instance 1
Insurance contract or identification number0918365
Number of Individuals Covered144
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $8,484
Total amount of fees paid to insurance companyUSD $35,355
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $733,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,484
Amount paid for insurance broker fees35355
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0224263
Policy instance 1
Insurance contract or identification number0224263
Number of Individuals Covered107
Insurance policy start date2019-05-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $967
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $122,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $967
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0224263
Policy instance 1
Insurance contract or identification number0224263
Number of Individuals Covered104
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $6,163
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $770,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,163
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0224263
Policy instance 1
Insurance contract or identification number0224263
Number of Individuals Covered122
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $5,736
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $696,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,736
Insurance broker nameCBIZ BENEFITS & INSURANCE SVCS INC

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