CHANCELLOR HEALTH PARTNERS, INC. has sponsored the creation of one or more 401k plans.
Additional information about CHANCELLOR HEALTH PARTNERS, INC.
Submission information for form 5500 for 401k plan CHANCELLOR HEALTH PARTNERS, INC.
401k plan membership statisitcs for CHANCELLOR HEALTH PARTNERS, INC.
| Measure | Date | Value |
|---|
| 2018: CHANCELLOR HEALTH PARTNERS, INC. 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-05-01 | 387 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 415 |
| Total of all active and inactive participants | 2018-05-01 | 415 |
| 2017: CHANCELLOR HEALTH PARTNERS, INC. 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-05-01 | 298 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 387 |
| Total of all active and inactive participants | 2017-05-01 | 387 |
| 2016: CHANCELLOR HEALTH PARTNERS, INC. 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-05-01 | 440 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 298 |
| Total of all active and inactive participants | 2016-05-01 | 298 |
| 2015: CHANCELLOR HEALTH PARTNERS, INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 362 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 440 |
| Total of all active and inactive participants | 2015-05-01 | 440 |
| 2014: CHANCELLOR HEALTH PARTNERS, INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 321 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 362 |
| Total of all active and inactive participants | 2014-05-01 | 362 |
| 2013: CHANCELLOR HEALTH PARTNERS, INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 245 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 321 |
| Total of all active and inactive participants | 2013-05-01 | 321 |
| 2012: CHANCELLOR HEALTH PARTNERS, INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 202 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 245 |
| Total of all active and inactive participants | 2012-05-01 | 245 |
| 2011: CHANCELLOR HEALTH PARTNERS, INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 204 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 202 |
| Total of all active and inactive participants | 2011-04-01 | 202 |
| 2010: CHANCELLOR HEALTH PARTNERS, INC. 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-04-01 | 175 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-04-01 | 204 |
| Total of all active and inactive participants | 2010-04-01 | 204 |
| 2009: CHANCELLOR HEALTH PARTNERS, INC. 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 175 |
| Total of all active and inactive participants | 2009-04-01 | 175 |
| 2007: CHANCELLOR HEALTH PARTNERS, INC. 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-04-01 | 162 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-04-01 | 161 |
| Total of all active and inactive participants | 2007-04-01 | 161 |
| Total participants | 2007-04-01 | 161 |
| 2005: CHANCELLOR HEALTH PARTNERS, INC. 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-04-01 | 192 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-04-01 | 148 |
| Total of all active and inactive participants | 2005-04-01 | 148 |
| Total participants | 2005-04-01 | 148 |
| 2004: CHANCELLOR HEALTH PARTNERS, INC. 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-04-01 | 192 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-04-01 | 192 |
| Total of all active and inactive participants | 2004-04-01 | 192 |
| Total participants | 2004-04-01 | 192 |
| 2018: CHANCELLOR HEALTH PARTNERS, INC. 2018 form 5500 responses |
|---|
| 2018-05-01 | Type of plan entity | Single employer plan |
| 2018-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-05-01 | Plan funding arrangement – Insurance | Yes |
| 2018-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: CHANCELLOR HEALTH PARTNERS, INC. 2017 form 5500 responses |
|---|
| 2017-05-01 | Type of plan entity | Single employer plan |
| 2017-05-01 | Plan funding arrangement – Insurance | Yes |
| 2017-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: CHANCELLOR HEALTH PARTNERS, INC. 2016 form 5500 responses |
|---|
| 2016-05-01 | Type of plan entity | Single employer plan |
| 2016-05-01 | Plan funding arrangement – Insurance | Yes |
| 2016-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: CHANCELLOR HEALTH PARTNERS, INC. 2015 form 5500 responses |
|---|
| 2015-05-01 | Type of plan entity | Single employer plan |
| 2015-05-01 | Plan funding arrangement – Insurance | Yes |
| 2015-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: CHANCELLOR HEALTH PARTNERS, INC. 2014 form 5500 responses |
|---|
| 2014-05-01 | Type of plan entity | Single employer plan |
| 2014-05-01 | Plan funding arrangement – Insurance | Yes |
| 2014-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: CHANCELLOR HEALTH PARTNERS, INC. 2013 form 5500 responses |
|---|
| 2013-05-01 | Type of plan entity | Single employer plan |
| 2013-05-01 | Plan funding arrangement – Insurance | Yes |
| 2013-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: CHANCELLOR HEALTH PARTNERS, INC. 2012 form 5500 responses |
|---|
| 2012-05-01 | Type of plan entity | Single employer plan |
| 2012-05-01 | Plan funding arrangement – Insurance | Yes |
| 2012-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: CHANCELLOR HEALTH PARTNERS, INC. 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: CHANCELLOR HEALTH PARTNERS, INC. 2010 form 5500 responses |
|---|
| 2010-04-01 | Type of plan entity | Single employer plan |
| 2010-04-01 | Plan funding arrangement – Insurance | Yes |
| 2010-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: CHANCELLOR HEALTH PARTNERS, INC. 2009 form 5500 responses |
|---|
| 2009-04-01 | Type of plan entity | Single employer plan |
| 2009-04-01 | Plan funding arrangement – Insurance | Yes |
| 2009-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: CHANCELLOR HEALTH PARTNERS, INC. 2007 form 5500 responses |
|---|
| 2007-04-01 | Type of plan entity | Single employer plan |
| 2007-04-01 | Submission has been amended | No |
| 2007-04-01 | This submission is the final filing | No |
| 2007-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-04-01 | Plan is a collectively bargained plan | No |
| 2007-04-01 | Plan funding arrangement – Insurance | Yes |
| 2007-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: CHANCELLOR HEALTH PARTNERS, INC. 2005 form 5500 responses |
|---|
| 2005-04-01 | Type of plan entity | Single employer plan |
| 2005-04-01 | Submission has been amended | No |
| 2005-04-01 | This submission is the final filing | No |
| 2005-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-04-01 | Plan is a collectively bargained plan | No |
| 2005-04-01 | Plan funding arrangement – Insurance | Yes |
| 2005-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: CHANCELLOR HEALTH PARTNERS, INC. 2004 form 5500 responses |
|---|
| 2004-04-01 | Type of plan entity | Single employer plan |
| 2004-04-01 | First time form 5500 has been submitted | Yes |
| 2004-04-01 | Submission has been amended | No |
| 2004-04-01 | This submission is the final filing | No |
| 2004-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2004-04-01 | Plan is a collectively bargained plan | No |
| 2004-04-01 | Plan funding arrangement – Insurance | Yes |
| 2004-04-01 | Plan benefit arrangement – Insurance | Yes |
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 321704 |
| Policy instance | 3 |
| Insurance contract or identification number | 321704 | | Number of Individuals Covered | 249 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $1,659 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,221 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,659 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 00247774 |
| Policy instance | 2 |
| Insurance contract or identification number | 00247774 | | Number of Individuals Covered | 336 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $13,500 | | Total amount of fees paid to insurance company | USD $4,824 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,145,171 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,500 | | Amount paid for insurance broker fees | 4320 | | Additional information about fees paid to insurance broker | PURPOSE OF THESE FEES IS INCENTIVES, EDUCATION, COMMUNICATION AND TRA | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 303263 |
| Policy instance | 1 |
| Insurance contract or identification number | 303263 | | Number of Individuals Covered | 415 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $3,973 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $61,151 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,973 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 303263 |
| Policy instance | 1 |
| Insurance contract or identification number | 303263 | | Number of Individuals Covered | 387 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $16,073 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $138,542 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 00247774 |
| Policy instance | 2 |
| Insurance contract or identification number | 00247774 | | Number of Individuals Covered | 353 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $47,241 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,310,367 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 321704 |
| Policy instance | 3 |
| Insurance contract or identification number | 321704 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $4,099 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,673 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
| Policy contract number | 30040329 |
| Policy instance | 3 |
| Insurance contract or identification number | 30040329 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,394 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 303263 |
| Policy instance | 2 |
| Insurance contract or identification number | 303263 | | Number of Individuals Covered | 320 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $5,996 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $89,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,996 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | HUNTINGTON INSURANCE INC |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744369 |
| Policy instance | 1 |
| Insurance contract or identification number | 744369 | | Number of Individuals Covered | 440 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $5,210 | | Total amount of fees paid to insurance company | USD $35,255 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,205,198 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,210 | | Amount paid for insurance broker fees | 35255 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 | | Insurance broker name | HUNTINGTON INSURANCE INC |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
| Policy contract number | 30040329 |
| Policy instance | 3 |
| Insurance contract or identification number | 30040329 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,960 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 303263 |
| Policy instance | 2 |
| Insurance contract or identification number | 303263 | | Number of Individuals Covered | 320 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $5,996 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $89,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,996 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | HUNTINGTON INSURANCE INC |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744369 |
| Policy instance | 1 |
| Insurance contract or identification number | 744369 | | Number of Individuals Covered | 362 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $4,188 | | Total amount of fees paid to insurance company | USD $31,570 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,781,648 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,188 | | Amount paid for insurance broker fees | 31570 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 | | Insurance broker name | HUNTINGTON INSURANCE INC |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744369 |
| Policy instance | 1 |
| Insurance contract or identification number | 744369 | | Number of Individuals Covered | 321 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $33,087 | | Total amount of fees paid to insurance company | USD $3,021 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,533,129 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $33,178 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | WELS FARGO INS SERVICES OF MN INC |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 225 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $5,095 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,989 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,095 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0744369 |
| Policy instance | 1 |
| Insurance contract or identification number | 0744369 | | Number of Individuals Covered | 245 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $26,617 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,245,279 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,617 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 9021402106 000 |
| Policy instance | 2 |
| Insurance contract or identification number | 9021402106 000 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of fees paid to insurance company | USD $5,388 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $74,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 000003927 |
| Policy instance | 1 |
| Insurance contract or identification number | 000003927 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $22,253 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,107,343 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 9021402106 |
| Policy instance | 2 |
| Insurance contract or identification number | 9021402106 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $60,208 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 000003927 |
| Policy instance | 1 |
| Insurance contract or identification number | 000003927 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $22,429 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $994,526 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 9021402106 |
| Policy instance | 1 |
| Insurance contract or identification number | 9021402106 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2008-04-01 | | Insurance policy end date | 2009-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $59,479 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Insurance broker name | COMPANION LIFE INSURANCE COMPANY |
|
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 00091585 |
| Policy instance | 2 |
| Insurance contract or identification number | 00091585 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2008-04-01 | | Insurance policy end date | 2009-03-31 | | Total amount of commissions paid to insurance broker | USD $23,067 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $848,903 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 23067 | | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 9021402106 |
| Policy instance | 2 |
| Insurance contract or identification number | 9021402106 | | Number of Individuals Covered | 161 | | Insurance policy start date | 2007-04-01 | | Insurance policy end date | 2008-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,749 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Insurance broker name | COMPANION LIFE INSURANCE COMPANY |
|
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 00091585 |
| Policy instance | 1 |
| Insurance contract or identification number | 00091585 | | Number of Individuals Covered | 161 | | Insurance policy start date | 2007-04-01 | | Insurance policy end date | 2008-03-31 | | Total amount of commissions paid to insurance broker | USD $22,099 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $784,663 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 22099 | | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
|
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 00091585 |
| Policy instance | 2 |
| Insurance contract or identification number | 00091585 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2006-04-01 | | Insurance policy end date | 2007-03-31 | | Total amount of commissions paid to insurance broker | USD $22,154 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $809,451 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 22154 | | Insurance broker name | ACRODIA OF OHIO, LLC |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 9021402106 |
| Policy instance | 1 |
| Insurance contract or identification number | 9021402106 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2006-04-01 | | Insurance policy end date | 2007-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,019 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Insurance broker name | COMPANION LIFE INSURANCE COMPANY |
|
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 00091585 |
| Policy instance | 1 |
| Insurance contract or identification number | 00091585 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2005-04-01 | | Insurance policy end date | 2006-03-31 | | Total amount of commissions paid to insurance broker | USD $17,491 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $709,902 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 17491 | | Insurance broker name | ACRODIA OF OHIO, LLC |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 9021402106 |
| Policy instance | 2 |
| Insurance contract or identification number | 9021402106 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2005-04-01 | | Insurance policy end date | 2006-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,857 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Insurance broker name | COMPANION LIFE INSURANCE COMPANY |
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| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 00091585 |
| Policy instance | 1 |
| Insurance contract or identification number | 00091585 | | Number of Individuals Covered | 192 | | Insurance policy start date | 2004-04-01 | | Insurance policy end date | 2005-03-31 | | Total amount of commissions paid to insurance broker | USD $11,902 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $393,834 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 11902 | | Insurance broker name | ACRODIA OF OHIO, LLC |
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| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 9021402106 |
| Policy instance | 2 |
| Insurance contract or identification number | 9021402106 | | Number of Individuals Covered | 192 | | Insurance policy start date | 2004-04-01 | | Insurance policy end date | 2005-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,587 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Insurance broker name | COMPANION LIFE INSURANCE COMPANY |
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