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CLICKSOFTWARE, INC. 401k Plan overview

Plan NameCLICKSOFTWARE, INC.
Plan identification number 504

CLICKSOFTWARE, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CLICKSOFTWARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:CLICKSOFTWARE, INC.
Employer identification number (EIN):954252722
NAIC Classification:541511
NAIC Description:Custom Computer Programming Services

Additional information about CLICKSOFTWARE, INC.

Jurisdiction of Incorporation: California Department of State
Incorporation Date: 1989-09-29
Company Identification Number: C1650909
Legal Registered Office Address: 4687 Pine Valley

Westlake Village
United States of America (USA)
91362

More information about CLICKSOFTWARE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLICKSOFTWARE, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042019-04-01KIM COLEMAN2020-07-17
5042018-04-01JAY SCHAUFELD2019-08-26
5042017-04-01
5042016-04-01MEREDITH WILLOUGHBY
5042015-04-01JESSICA LOCKHART
5042014-04-01MICHELLE KEEFE
5042013-04-01MICHELE KEEFE
5042012-04-01MICHELE KEEFE

Plan Statistics for CLICKSOFTWARE, INC.

401k plan membership statisitcs for CLICKSOFTWARE, INC.

Measure Date Value
2019: CLICKSOFTWARE, INC. 2019 401k membership
Total participants, beginning-of-year2019-04-01173
Total number of active participants reported on line 7a of the Form 55002019-04-010
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-010
2018: CLICKSOFTWARE, INC. 2018 401k membership
Total participants, beginning-of-year2018-04-01147
Total number of active participants reported on line 7a of the Form 55002018-04-01170
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-013
Total of all active and inactive participants2018-04-01173
Number of employers contributing to the scheme2018-04-010
2017: CLICKSOFTWARE, INC. 2017 401k membership
Total participants, beginning-of-year2017-04-01126
Total number of active participants reported on line 7a of the Form 55002017-04-01119
Number of retired or separated participants receiving benefits2017-04-017
Number of other retired or separated participants entitled to future benefits2017-04-016
Total of all active and inactive participants2017-04-01132
Number of employers contributing to the scheme2017-04-010
2016: CLICKSOFTWARE, INC. 2016 401k membership
Total participants, beginning-of-year2016-04-01116
Total number of active participants reported on line 7a of the Form 55002016-04-01126
Total of all active and inactive participants2016-04-01126
2015: CLICKSOFTWARE, INC. 2015 401k membership
Total participants, beginning-of-year2015-04-01157
Total number of active participants reported on line 7a of the Form 55002015-04-01116
Total of all active and inactive participants2015-04-01116
2014: CLICKSOFTWARE, INC. 2014 401k membership
Total participants, beginning-of-year2014-04-01115
Total number of active participants reported on line 7a of the Form 55002014-04-01157
Total of all active and inactive participants2014-04-01157
2013: CLICKSOFTWARE, INC. 2013 401k membership
Total participants, beginning-of-year2013-04-01247
Total number of active participants reported on line 7a of the Form 55002013-04-01321
Total of all active and inactive participants2013-04-01321
2012: CLICKSOFTWARE, INC. 2012 401k membership
Total participants, beginning-of-year2012-04-010
Total number of active participants reported on line 7a of the Form 55002012-04-01247
Total of all active and inactive participants2012-04-01247

Financial Data on CLICKSOFTWARE, INC.

Measure Date Value
2014 : CLICKSOFTWARE, INC. 2014 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-03-31No
Was this plan covered by a fidelity bond2014-03-31No
If this is an individual account plan, was there a blackout period2014-03-31No
Were there any nonexempt tranactions with any party-in-interest2014-03-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-03-31No
Were any leases to which the plan was party in default or uncollectible2014-03-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-03-31No
Was there a failure to transmit to the plan any participant contributions2014-03-31No
Has the plan failed to provide any benefit when due under the plan2014-03-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-03-31No
Did the plan have assets held for investment2014-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-03-31No
2013 : CLICKSOFTWARE, INC. 2013 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-03-31No
Was this plan covered by a fidelity bond2013-03-31No
If this is an individual account plan, was there a blackout period2013-03-31No
Were there any nonexempt tranactions with any party-in-interest2013-03-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-03-31No
Were any leases to which the plan was party in default or uncollectible2013-03-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-03-31No
Was there a failure to transmit to the plan any participant contributions2013-03-31No
Has the plan failed to provide any benefit when due under the plan2013-03-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-03-31No
Did the plan have assets held for investment2013-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-03-31No

Form 5500 Responses for CLICKSOFTWARE, INC.

2019: CLICKSOFTWARE, INC. 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingYes
2019-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – General assets of the sponsorYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – General assets of the sponsorYes
2018: CLICKSOFTWARE, INC. 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – General assets of the sponsorYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – General assets of the sponsorYes
2017: CLICKSOFTWARE, INC. 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: CLICKSOFTWARE, INC. 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: CLICKSOFTWARE, INC. 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: CLICKSOFTWARE, INC. 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: CLICKSOFTWARE, INC. 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: CLICKSOFTWARE, INC. 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01First time form 5500 has been submittedYes
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97832181001ETAL
Policy instance 4
Insurance contract or identification number97832181001ETAL
Number of Individuals Covered308
Insurance policy start date2019-04-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,463
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $14,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,463
Insurance broker organization code?3
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number12860
Policy instance 3
Insurance contract or identification number12860
Number of Individuals Covered387
Insurance policy start date2019-04-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,763
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $160,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,763
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number549049
Policy instance 2
Insurance contract or identification number549049
Number of Individuals Covered162
Insurance policy start date2019-04-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $10,315
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $103,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,315
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00622170
Policy instance 1
Insurance contract or identification number00622170
Number of Individuals Covered225
Insurance policy start date2019-04-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $74,509
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,330,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees74509
Additional information about fees paid to insurance brokerBENEFIT ADVISOR & SERVICE/GENERAL AGENT FEES
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00622170
Policy instance 1
Insurance contract or identification number00622170
Number of Individuals Covered227
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $99,288
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,985,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees99288
Additional information about fees paid to insurance brokerBENEFIT ADVISOR & SERVICE/GENERAL AGENT FEES
Insurance broker organization code?3
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number549049
Policy instance 2
Insurance contract or identification number549049
Number of Individuals Covered170
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $10,919
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $118,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $8,878
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number12860
Policy instance 3
Insurance contract or identification number12860
Number of Individuals Covered422
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $6,560
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $213,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,560
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97832181001
Policy instance 4
Insurance contract or identification number97832181001
Number of Individuals Covered331
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $1,547
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $861
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4958342
Policy instance 1
Insurance contract or identification number4958342
Number of Individuals Covered369
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $37,801
Total amount of fees paid to insurance companyUSD $47
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $31,097
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMMISSION
Insurance broker nameUSI INSURANCE SERVICES, LLC
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208520001
Policy instance 5
Insurance contract or identification number0208520001
Number of Individuals Covered10
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $165
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $165
Insurance broker nameBRUCE CROHN, LLC
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0823200004
Policy instance 4
Insurance contract or identification number0823200004
Number of Individuals Covered34
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $3,551
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,551
Insurance broker organization code?3
Insurance broker nameBRUCE CROHN, LLC
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0823200001
Policy instance 3
Insurance contract or identification number0823200001
Number of Individuals Covered7
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $1,084
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,084
Insurance broker nameBRUCE CROHN, LLC
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0823200000
Policy instance 2
Insurance contract or identification number0823200000
Number of Individuals Covered141
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $14,544
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $849,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,544
Insurance broker nameBRUCE CROHN, LLC
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208520000
Policy instance 1
Insurance contract or identification number0208520000
Number of Individuals Covered138
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $12,162
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $710,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,162
Insurance broker nameBRUCE CROHN, LLC
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0823200002
Policy instance 6
Insurance contract or identification number0823200002
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $1,098
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
Welfare Benefit Premiums Paid to CarrierUSD $62,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,098
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0823200004
Policy instance 5
Insurance contract or identification number0823200004
Number of Individuals Covered54
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $1,443
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
Welfare Benefit Premiums Paid to CarrierUSD $67,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,443
Insurance broker organization code?3
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208520002
Policy instance 4
Insurance contract or identification number0208520002
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $28
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
Welfare Benefit Premiums Paid to CarrierUSD $1,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28
Insurance broker organization code?3
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0823200001
Policy instance 3
Insurance contract or identification number0823200001
Number of Individuals Covered17
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $586
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
Welfare Benefit Premiums Paid to CarrierUSD $29,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $586
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0823200000
Policy instance 2
Insurance contract or identification number0823200000
Number of Individuals Covered174
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $15,306
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
Welfare Benefit Premiums Paid to CarrierUSD $713,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,306
Insurance broker nameBRUCE CROHN LLC
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208520000
Policy instance 1
Insurance contract or identification number0208520000
Number of Individuals Covered180
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $15,084
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
Welfare Benefit Premiums Paid to CarrierUSD $703,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,084
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208520000
Policy instance 2
Insurance contract or identification number0208520000
Number of Individuals Covered173
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $17,111
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 $17,111
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208520001
Policy instance 1
Insurance contract or identification number0208520001
Number of Individuals Covered0
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $193
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
Welfare Benefit Premiums Paid to CarrierUSD $7,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $193
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0823200000
Policy instance 3
Insurance contract or identification number0823200000
Number of Individuals Covered134
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $14,789
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
Other welfare benefits providedNNP
Welfare Benefit Premiums Paid to CarrierUSD $578,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,789
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0823200001
Policy instance 4
Insurance contract or identification number0823200001
Number of Individuals Covered14
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $528
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
Other welfare benefits providedNNP
Welfare Benefit Premiums Paid to CarrierUSD $20,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $528
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208530001
Policy instance 4
Insurance contract or identification number0208530001
Number of Individuals Covered0
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $1
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
Welfare Benefit Premiums Paid to CarrierUSD $47
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208530000
Policy instance 3
Insurance contract or identification number0208530000
Number of Individuals Covered91
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $10,817
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
Welfare Benefit Premiums Paid to CarrierUSD $431,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,817
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208520000
Policy instance 2
Insurance contract or identification number0208520000
Number of Individuals Covered152
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $15,754
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
Welfare Benefit Premiums Paid to CarrierUSD $629,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,754
Insurance broker nameBRUCE CROHN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0208520001
Policy instance 1
Insurance contract or identification number0208520001
Number of Individuals Covered4
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $419
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
Welfare Benefit Premiums Paid to CarrierUSD $16,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $419
Insurance broker nameBRUCE CROHN

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