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GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 401k Plan overview

Plan NameGROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN
Plan identification number 501

GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 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
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

MITUTOYO AMERICA CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:MITUTOYO AMERICA CORPORATION
Employer identification number (EIN):131980272
NAIC Classification:332900

Additional information about MITUTOYO AMERICA CORPORATION

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1963-01-14
Company Identification Number: 153687
Legal Registered Office Address: 600 MAMARONECK AVENUE #400
New York
HARRISON
United States of America (USA)
10528

More information about MITUTOYO AMERICA CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01NICOLE SMITH2023-07-05
5012021-01-01NICOLE SMITH2022-07-14
5012020-04-01SUSAN HALLSBY2021-08-11
5012019-04-01SUSAN HALLSBY2020-06-08
5012018-04-01MICHELLE BRAZEE2019-10-30
5012017-04-01
5012016-04-01SUSAN HALLSBY
5012015-04-01S. SASAKI
5012014-04-01S. SASAKI
5012013-04-01S. SASAKI
5012012-04-01S. SASAKI
5012011-04-01S. SASAKI
5012009-04-01M. YAMASHITA

Plan Statistics for GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN

401k plan membership statisitcs for GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN

Measure Date Value
2022: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01689
Total number of active participants reported on line 7a of the Form 55002022-01-01739
Total of all active and inactive participants2022-01-01739
2021: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01701
Total number of active participants reported on line 7a of the Form 55002021-01-01689
Total of all active and inactive participants2021-01-01689
2020: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01725
Total number of active participants reported on line 7a of the Form 55002020-04-01701
Total of all active and inactive participants2020-04-01701
2019: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01684
Total number of active participants reported on line 7a of the Form 55002019-04-01725
Total of all active and inactive participants2019-04-01725
2018: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01661
Total number of active participants reported on line 7a of the Form 55002018-04-01684
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01684
2017: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01655
Total number of active participants reported on line 7a of the Form 55002017-04-01661
Total of all active and inactive participants2017-04-01661
2016: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01655
Total number of active participants reported on line 7a of the Form 55002016-04-01655
Total of all active and inactive participants2016-04-01655
2015: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01611
Total number of active participants reported on line 7a of the Form 55002015-04-01655
Total of all active and inactive participants2015-04-01655
2014: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01621
Total number of active participants reported on line 7a of the Form 55002014-04-01611
Total of all active and inactive participants2014-04-01611
2013: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01606
Total number of active participants reported on line 7a of the Form 55002013-04-01621
Total of all active and inactive participants2013-04-01621
2012: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01563
Total number of active participants reported on line 7a of the Form 55002012-04-01606
Total of all active and inactive participants2012-04-01606
2011: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01576
Total number of active participants reported on line 7a of the Form 55002011-04-01563
Total of all active and inactive participants2011-04-01563
2009: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01235
Total number of active participants reported on line 7a of the Form 55002009-04-01238
Number of retired or separated participants receiving benefits2009-04-010
Number of other retired or separated participants entitled to future benefits2009-04-010
Total of all active and inactive participants2009-04-01238

Form 5500 Responses for GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN

2022: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – General assets of the sponsorYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – General assets of the sponsorYes
2019: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
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: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 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: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – General assets of the sponsorYes
2016: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – General assets of the sponsorYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – General assets of the sponsorYes
2015: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – General assets of the sponsorYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – General assets of the sponsorYes
2014: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – General assets of the sponsorYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – General assets of the sponsorYes
2013: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan funding arrangement – General assets of the sponsorYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – General assets of the sponsorYes
2012: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan funding arrangement – General assets of the sponsorYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – General assets of the sponsorYes
2011: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan funding arrangement – General assets of the sponsorYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – General assets of the sponsorYes
2009: GROUP LIFE, HEALTH, AND LONG TERM DISABILITY PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01This submission is the final filingNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10329051001
Policy instance 5
Insurance contract or identification number10329051001
Number of Individuals Covered2
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $33
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BJ8X
Policy instance 4
Insurance contract or identification numberG000BJ8X
Number of Individuals Covered319
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $30,936
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $154,677
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,936
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00560576
Policy instance 3
Insurance contract or identification number00560576
Number of Individuals Covered333
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $26,856
Total amount of fees paid to insurance companyUSD $398
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,560
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,856
Amount paid for insurance broker fees398
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10116781001
Policy instance 2
Insurance contract or identification number10116781001
Number of Individuals Covered584
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,689
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,689
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number689857
Policy instance 1
Insurance contract or identification number689857
Number of Individuals Covered739
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $89,654
Total amount of fees paid to insurance companyUSD $1,415
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 $89,654
Amount paid for insurance broker fees1415
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number689857
Policy instance 1
Insurance contract or identification number689857
Number of Individuals Covered689
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $84,979
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,742,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $84,979
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10116781001
Policy instance 2
Insurance contract or identification number10116781001
Number of Individuals Covered507
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,717
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,715
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00560576
Policy instance 3
Insurance contract or identification number00560576
Number of Individuals Covered279
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $25,084
Total amount of fees paid to insurance companyUSD $3,040
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,084
Amount paid for insurance broker fees3040
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BJ8X
Policy instance 4
Insurance contract or identification numberG000BJ8X
Number of Individuals Covered309
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $22,434
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $112,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,434
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number689857
Policy instance 1
Insurance contract or identification number689857
Number of Individuals Covered701
Insurance policy start date2020-04-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $65,304
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,962,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,304
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00560576
Policy instance 3
Insurance contract or identification number00560576
Number of Individuals Covered290
Insurance policy start date2020-04-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $21,747
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,747
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10116781001
Policy instance 2
Insurance contract or identification number10116781001
Number of Individuals Covered516
Insurance policy start date2020-04-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,437
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,437
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BJ8X
Policy instance 4
Insurance contract or identification numberG000BJ8X
Number of Individuals Covered318
Insurance policy start date2020-04-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $22,138
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $110,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,138
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number689857
Policy instance 1
Insurance contract or identification number689857
Number of Individuals Covered725
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $85,829
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,860,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $85,829
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10116781001
Policy instance 2
Insurance contract or identification number10116781001
Number of Individuals Covered510
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $2,881
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $32,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,881
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00560576
Policy instance 3
Insurance contract or identification number00560576
Number of Individuals Covered299
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $23,752
Total amount of fees paid to insurance companyUSD $615
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,752
Amount paid for insurance broker fees615
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BJ8X
Policy instance 4
Insurance contract or identification numberG000BJ8X
Number of Individuals Covered331
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $27,483
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $137,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,483
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number689857
Policy instance 1
Insurance contract or identification number689857
Number of Individuals Covered684
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $59,308
Total amount of fees paid to insurance companyUSD $1,695
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,609,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,747
Amount paid for insurance broker fees1695
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10116781001
Policy instance 3
Insurance contract or identification number10116781001
Number of Individuals Covered391
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,593
Total amount of fees paid to insurance companyUSD $22
Welfare Benefit Premiums Paid to CarrierUSD $26,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,593
Amount paid for insurance broker fees22
Additional information about fees paid to insurance brokerMARKETING FEES
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141129
Policy instance 2
Insurance contract or identification number0141129
Number of Individuals Covered470
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $9,337
Total amount of fees paid to insurance companyUSD $2,312
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $134,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,427
Amount paid for insurance broker fees2312
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION & MARKETING FEES
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number11235915
Policy instance 4
Insurance contract or identification number11235915
Number of Individuals Covered674
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $8,824
Total amount of fees paid to insurance companyUSD $4,340
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $294,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,339
Amount paid for insurance broker fees4340
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION & MARKETING FEES
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number11235915
Policy instance 4
Insurance contract or identification number11235915
Number of Individuals Covered652
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $8,974
Total amount of fees paid to insurance companyUSD $5,785
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $299,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,974
Amount paid for insurance broker fees5785
Additional information about fees paid to insurance brokerSUPPLEMENTAL AND NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10116781001
Policy instance 3
Insurance contract or identification number10116781001
Number of Individuals Covered385
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,257
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $24,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,257
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141129
Policy instance 2
Insurance contract or identification number0141129
Number of Individuals Covered450
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $9,088
Total amount of fees paid to insurance companyUSD $2,411
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $124,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,088
Amount paid for insurance broker fees2411
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number689857
Policy instance 1
Insurance contract or identification number689857
Number of Individuals Covered661
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $57,804
Total amount of fees paid to insurance companyUSD $1,581
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,465,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,804
Amount paid for insurance broker fees1581
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1123915
Policy instance 1
Insurance contract or identification number1123915
Number of Individuals Covered655
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $8,819
Total amount of fees paid to insurance companyUSD $5,138
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $273,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,819
Insurance broker organization code?3
Amount paid for insurance broker fees5091
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141129
Policy instance 2
Insurance contract or identification number0141129
Number of Individuals Covered469
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $8,772
Total amount of fees paid to insurance companyUSD $2,258
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $117,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,772
Insurance broker organization code?3
Amount paid for insurance broker fees2178
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number689857
Policy instance 3
Insurance contract or identification number689857
Number of Individuals Covered667
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $52,726
Total amount of fees paid to insurance companyUSD $1,596
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $319,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,726
Insurance broker organization code?3
Amount paid for insurance broker fees1559
Additional information about fees paid to insurance brokerSPECIAL PROGRAM
Insurance broker nameMERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141129
Policy instance 2
Insurance contract or identification number0141129
Number of Individuals Covered454
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $7,709
Total amount of fees paid to insurance companyUSD $1,748
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $109,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,709
Insurance broker organization code?3
Amount paid for insurance broker fees1729
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1123915
Policy instance 1
Insurance contract or identification number1123915
Number of Individuals Covered611
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $7,240
Total amount of fees paid to insurance companyUSD $4,187
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 $263,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,240
Insurance broker organization code?3
Amount paid for insurance broker fees4168
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number689857
Policy instance 3
Insurance contract or identification number689857
Number of Individuals Covered626
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $49,890
Total amount of fees paid to insurance companyUSD $1,799
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 $270,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,890
Insurance broker organization code?3
Amount paid for insurance broker fees1748
Additional information about fees paid to insurance brokerSPECIAL PROGRAM
Insurance broker nameMITUTOYO AMERICA CORPORATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1123915
Policy instance 1
Insurance contract or identification number1123915
Number of Individuals Covered606
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $8,426
Total amount of fees paid to insurance companyUSD $5,422
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 $258,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,426
Insurance broker organization code?3
Amount paid for insurance broker fees5402
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141129
Policy instance 2
Insurance contract or identification number0141129
Number of Individuals Covered469
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $8,028
Total amount of fees paid to insurance companyUSD $2,073
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $107,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,028
Insurance broker organization code?3
Amount paid for insurance broker fees2053
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP89857
Policy instance 3
Insurance contract or identification numberP89857
Number of Individuals Covered621
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $43,690
Total amount of fees paid to insurance companyUSD $35
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 $253,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,935
Insurance broker organization code?3
Amount paid for insurance broker fees24
Additional information about fees paid to insurance brokerMISCELLANEOUS GIFTS, MEALS, ETC.
Insurance broker nameMITUTOYO AMERICA CORPORATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141129
Policy instance 2
Insurance contract or identification number0141129
Number of Individuals Covered401
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $7,491
Total amount of fees paid to insurance companyUSD $1,296
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $92,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,491
Insurance broker organization code?3
Amount paid for insurance broker fees1270
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP89857
Policy instance 3
Insurance contract or identification numberP89857
Number of Individuals Covered606
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $40,193
Total amount of fees paid to insurance companyUSD $1,729
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 $237,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,193
Insurance broker organization code?3
Amount paid for insurance broker fees1684
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker nameMITUTOYO AMERICA CORPORATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1123915
Policy instance 1
Insurance contract or identification number1123915
Number of Individuals Covered589
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $6,334
Total amount of fees paid to insurance companyUSD $2,809
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 $235,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,334
Insurance broker organization code?3
Amount paid for insurance broker fees2757
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP89857
Policy instance 3
Insurance contract or identification numberP89857
Number of Individuals Covered563
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $39,394
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 $207,909
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1123915
Policy instance 1
Insurance contract or identification number1123915
Number of Individuals Covered554
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $6,245
Total amount of fees paid to insurance companyUSD $2,194
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 $225,468
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141129
Policy instance 2
Insurance contract or identification number0141129
Number of Individuals Covered354
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $5,692
Total amount of fees paid to insurance companyUSD $843
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $85,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1123915
Policy instance 1
Insurance contract or identification number1123915
Number of Individuals Covered576
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $6,755
Total amount of fees paid to insurance companyUSD $4,310
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 $246,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,755
Insurance broker organization code?3
Amount paid for insurance broker fees4299
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141129
Policy instance 2
Insurance contract or identification number0141129
Number of Individuals Covered353
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $6,595
Total amount of fees paid to insurance companyUSD $1,394
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $79,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,595
Insurance broker organization code?3
Amount paid for insurance broker fees1383
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameMERCER HEALTH & BENEFITS
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP89857
Policy instance 3
Insurance contract or identification numberP89857
Number of Individuals Covered544
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $37,080
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 $152,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,080
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number715595
Policy instance 4
Insurance contract or identification number715595
Insurance policy start date2009-04-01
Insurance policy end date2010-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,676
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1676
Additional information about fees paid to insurance brokerFSA CLAIMS PROCESSOR
Insurance broker name

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