JEWISH COMMUNITY HEALTH PLAN has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2022 : JEWISH COMMUNITY HEALTH PLAN 2022 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $663,812 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $483,471 |
| Total income from all sources (including contributions) | 2022-06-30 | $5,972,754 |
| Total of all expenses incurred | 2022-06-30 | $5,986,365 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-06-30 | $5,913,524 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-06-30 | $5,972,754 |
| Value of total assets at end of year | 2022-06-30 | $705,630 |
| Value of total assets at beginning of year | 2022-06-30 | $538,900 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-06-30 | $72,841 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-06-30 | No |
| Administrative expenses professional fees incurred | 2022-06-30 | $29,277 |
| Was this plan covered by a fidelity bond | 2022-06-30 | Yes |
| Value of fidelity bond cover | 2022-06-30 | $30,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-06-30 | $5,669 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-06-30 | $11,345 |
| Administrative expenses (other) incurred | 2022-06-30 | $37,319 |
| Liabilities. Value of operating payables at end of year | 2022-06-30 | $663,812 |
| Liabilities. Value of operating payables at beginning of year | 2022-06-30 | $483,471 |
| Total non interest bearing cash at end of year | 2022-06-30 | $699,961 |
| Total non interest bearing cash at beginning of year | 2022-06-30 | $527,555 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Value of net income/loss | 2022-06-30 | $-13,611 |
| Value of net assets at end of year (total assets less liabilities) | 2022-06-30 | $41,818 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-06-30 | $55,429 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-06-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-06-30 | $5,913,524 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-06-30 | No |
| Contributions received in cash from employer | 2022-06-30 | $5,972,754 |
| Contract administrator fees | 2022-06-30 | $6,245 |
| Did the plan have assets held for investment | 2022-06-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-06-30 | Unqualified |
| Accountancy firm name | 2022-06-30 | GROSSMAN YANAK & FORD LLP |
| Accountancy firm EIN | 2022-06-30 | 251638525 |
| 2021 : JEWISH COMMUNITY HEALTH PLAN 2021 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $483,471 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $541,883 |
| Total income from all sources (including contributions) | 2021-06-30 | $6,795,291 |
| Total of all expenses incurred | 2021-06-30 | $6,782,880 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-06-30 | $6,724,633 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-06-30 | $6,795,291 |
| Value of total assets at end of year | 2021-06-30 | $538,900 |
| Value of total assets at beginning of year | 2021-06-30 | $584,901 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-06-30 | $58,247 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-06-30 | No |
| Administrative expenses professional fees incurred | 2021-06-30 | $15,743 |
| Was this plan covered by a fidelity bond | 2021-06-30 | Yes |
| Value of fidelity bond cover | 2021-06-30 | $30,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-06-30 | $11,345 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-06-30 | $5,240 |
| Administrative expenses (other) incurred | 2021-06-30 | $36,890 |
| Liabilities. Value of operating payables at end of year | 2021-06-30 | $483,471 |
| Liabilities. Value of operating payables at beginning of year | 2021-06-30 | $541,883 |
| Total non interest bearing cash at end of year | 2021-06-30 | $527,555 |
| Total non interest bearing cash at beginning of year | 2021-06-30 | $579,661 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Value of net income/loss | 2021-06-30 | $12,411 |
| Value of net assets at end of year (total assets less liabilities) | 2021-06-30 | $55,429 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-06-30 | $43,018 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-06-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-06-30 | $6,724,633 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-06-30 | No |
| Contributions received in cash from employer | 2021-06-30 | $6,795,291 |
| Contract administrator fees | 2021-06-30 | $5,614 |
| Did the plan have assets held for investment | 2021-06-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-06-30 | Unqualified |
| Accountancy firm name | 2021-06-30 | GROSSMAN YANAK & FORD LLP |
| Accountancy firm EIN | 2021-06-30 | 251638525 |
| 2020 : JEWISH COMMUNITY HEALTH PLAN 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $541,883 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $604,061 |
| Total income from all sources (including contributions) | 2020-06-30 | $7,219,055 |
| Total of all expenses incurred | 2020-06-30 | $7,209,487 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-06-30 | $7,145,031 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-06-30 | $7,219,055 |
| Value of total assets at end of year | 2020-06-30 | $584,901 |
| Value of total assets at beginning of year | 2020-06-30 | $637,511 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-06-30 | $64,456 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-06-30 | No |
| Administrative expenses professional fees incurred | 2020-06-30 | $19,950 |
| Was this plan covered by a fidelity bond | 2020-06-30 | Yes |
| Value of fidelity bond cover | 2020-06-30 | $30,000 |
| If this is an individual account plan, was there a blackout period | 2020-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-06-30 | $5,240 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-06-30 | $5,301 |
| Administrative expenses (other) incurred | 2020-06-30 | $39,095 |
| Liabilities. Value of operating payables at end of year | 2020-06-30 | $541,883 |
| Liabilities. Value of operating payables at beginning of year | 2020-06-30 | $604,061 |
| Total non interest bearing cash at end of year | 2020-06-30 | $579,661 |
| Total non interest bearing cash at beginning of year | 2020-06-30 | $632,210 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Value of net income/loss | 2020-06-30 | $9,568 |
| Value of net assets at end of year (total assets less liabilities) | 2020-06-30 | $43,018 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-06-30 | $33,450 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-06-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-06-30 | $7,145,031 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-06-30 | No |
| Contributions received in cash from employer | 2020-06-30 | $7,219,055 |
| Contract administrator fees | 2020-06-30 | $5,411 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-06-30 | No |
| Did the plan have assets held for investment | 2020-06-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-06-30 | Unqualified |
| Accountancy firm name | 2020-06-30 | GROSSMAN YANAK & FORD LLP |
| Accountancy firm EIN | 2020-06-30 | 251638525 |
| 2019 : JEWISH COMMUNITY HEALTH PLAN 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $604,061 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $550,875 |
| Total income from all sources (including contributions) | 2019-06-30 | $6,753,099 |
| Total of all expenses incurred | 2019-06-30 | $6,760,058 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-06-30 | $6,684,216 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-06-30 | $6,753,099 |
| Value of total assets at end of year | 2019-06-30 | $637,511 |
| Value of total assets at beginning of year | 2019-06-30 | $591,284 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-06-30 | $75,842 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-06-30 | No |
| Administrative expenses professional fees incurred | 2019-06-30 | $35,644 |
| Was this plan covered by a fidelity bond | 2019-06-30 | Yes |
| Value of fidelity bond cover | 2019-06-30 | $30,000 |
| If this is an individual account plan, was there a blackout period | 2019-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-06-30 | $5,301 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-06-30 | $16,746 |
| Administrative expenses (other) incurred | 2019-06-30 | $34,586 |
| Liabilities. Value of operating payables at end of year | 2019-06-30 | $604,061 |
| Liabilities. Value of operating payables at beginning of year | 2019-06-30 | $550,875 |
| Total non interest bearing cash at end of year | 2019-06-30 | $632,210 |
| Total non interest bearing cash at beginning of year | 2019-06-30 | $574,538 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Value of net income/loss | 2019-06-30 | $-6,959 |
| Value of net assets at end of year (total assets less liabilities) | 2019-06-30 | $33,450 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-06-30 | $40,409 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-06-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-06-30 | $6,684,216 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-06-30 | No |
| Contributions received in cash from employer | 2019-06-30 | $6,753,099 |
| Contract administrator fees | 2019-06-30 | $5,612 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-06-30 | No |
| Did the plan have assets held for investment | 2019-06-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-06-30 | Unqualified |
| Accountancy firm name | 2019-06-30 | GROSSMAN YANAK & FORD LLP |
| Accountancy firm EIN | 2019-06-30 | 251638525 |
| 2018 : JEWISH COMMUNITY HEALTH PLAN 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $550,875 |
| Total income from all sources (including contributions) | 2018-06-30 | $6,245,012 |
| Total of all expenses incurred | 2018-06-30 | $6,204,603 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-06-30 | $6,174,873 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-06-30 | $6,233,555 |
| Value of total assets at end of year | 2018-06-30 | $591,284 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-06-30 | $29,730 |
| Total interest from all sources | 2018-06-30 | $12 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-06-30 | No |
| Administrative expenses professional fees incurred | 2018-06-30 | $23,236 |
| Was this plan covered by a fidelity bond | 2018-06-30 | Yes |
| Value of fidelity bond cover | 2018-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2018-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-06-30 | $16,746 |
| Other income not declared elsewhere | 2018-06-30 | $11,445 |
| Administrative expenses (other) incurred | 2018-06-30 | $1,413 |
| Liabilities. Value of operating payables at end of year | 2018-06-30 | $550,875 |
| Total non interest bearing cash at end of year | 2018-06-30 | $574,538 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Value of net income/loss | 2018-06-30 | $40,409 |
| Value of net assets at end of year (total assets less liabilities) | 2018-06-30 | $40,409 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-06-30 | No |
| Interest earned on other investments | 2018-06-30 | $12 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-06-30 | $6,174,873 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-06-30 | No |
| Contributions received in cash from employer | 2018-06-30 | $6,233,555 |
| Contract administrator fees | 2018-06-30 | $5,081 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-06-30 | No |
| Did the plan have assets held for investment | 2018-06-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-06-30 | Unqualified |
| Accountancy firm name | 2018-06-30 | GROSSMAN YANAK AND FORD LLP |
| Accountancy firm EIN | 2018-06-30 | 251638525 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 913795 |
| Policy instance | 7 |
| Insurance contract or identification number | 913795 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $847 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $21,312 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $847 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 899 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $97,440 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,608,493 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $97,440 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | VARIOUS |
| Policy instance | 2 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 417 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $3,122 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,254 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,122 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | VARIOUS |
| Policy instance | 3 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 151 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $1,397 | | Total amount of fees paid to insurance company | USD $2,571 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,935 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,397 | | Amount paid for insurance broker fees | 1397 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 888010G |
| Policy instance | 4 |
| Insurance contract or identification number | 888010G | | Number of Individuals Covered | 23 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $944 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $944 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | VARIOUS |
| Policy instance | 5 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 95 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $2,100 | | Total amount of fees paid to insurance company | USD $3,770 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,997 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,100 | | Amount paid for insurance broker fees | 2015 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000913794 |
| Policy instance | 6 |
| Insurance contract or identification number | 000000913794 | | Number of Individuals Covered | 465 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $4,663 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $117,495 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,663 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 913795 |
| Policy instance | 7 |
| Insurance contract or identification number | 913795 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $686 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $17,001 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $686 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 913794 |
| Policy instance | 6 |
| Insurance contract or identification number | 913794 | | Number of Individuals Covered | 489 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $4,466 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $110,720 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,466 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | VARIOUS |
| Policy instance | 5 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 98 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $2,062 | | Total amount of fees paid to insurance company | USD $3,687 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,061 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,062 | | Amount paid for insurance broker fees | 1972 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 888010G |
| Policy instance | 4 |
| Insurance contract or identification number | 888010G | | Number of Individuals Covered | 1477 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $1,110 | | Total amount of fees paid to insurance company | USD $277 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $18,198 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,110 | | Amount paid for insurance broker fees | 277 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES. | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | VARIOUS |
| Policy instance | 3 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 142 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $1,362 | | Total amount of fees paid to insurance company | USD $2,475 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,233 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,362 | | Amount paid for insurance broker fees | 1362 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | VARIOUS |
| Policy instance | 2 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 415 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $3,514 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,753 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,514 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 927 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $109,741 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,497,640 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $109,741 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 1015 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $153,129 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,876,972 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,578 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | VARIOUS |
| Policy instance | 2 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 425 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $4,377 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,073 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,780 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | VARIOUS |
| Policy instance | 3 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 248 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $1,160 | | Total amount of fees paid to insurance company | USD $3,000 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $70,925 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2978 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $1,054 |
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 888010G |
| Policy instance | 4 |
| Insurance contract or identification number | 888010G | | Number of Individuals Covered | 1485 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $7,072 | | Total amount of fees paid to insurance company | USD $645 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $141,683 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,072 | | Amount paid for insurance broker fees | 645 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | VARIOUS |
| Policy instance | 2 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 224 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,570 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 1081 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,429,509 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | VARIOUS |
| Policy instance | 2 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 232 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,280 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 886 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,740,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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