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HEALTH PLAN OF CURATIVE CARE NETWORK 401k Plan overview

Plan NameHEALTH PLAN OF CURATIVE CARE NETWORK
Plan identification number 503

HEALTH PLAN OF CURATIVE CARE NETWORK Benefits

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

CURATIVE CARE NETWORK, INC. has sponsored the creation of one or more 401k plans.

Company Name:CURATIVE CARE NETWORK, INC.
Employer identification number (EIN):390806286
NAIC Classification:621340
NAIC Description:Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH PLAN OF CURATIVE CARE NETWORK

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032020-01-01
5032019-01-01
5032018-01-01
5032017-01-01JENNIFER NELSON
5032016-01-01JENNIFER NELSON
5032015-01-01JENNIFER NELSON JENNIFER NELSON2016-07-13
5032013-09-01MELISSA WIZA
5032012-09-01MELISSA WIZA
5032011-09-01MELISSA WIZA
5032011-01-01MELISSA WIZA
5032010-09-01MELISSA WIZA
5032009-09-01MELISSA WIZA
5032009-01-01MELISSA WIZA
5032009-01-01MELISSA WIZA

Plan Statistics for HEALTH PLAN OF CURATIVE CARE NETWORK

401k plan membership statisitcs for HEALTH PLAN OF CURATIVE CARE NETWORK

Measure Date Value
2020: HEALTH PLAN OF CURATIVE CARE NETWORK 2020 401k membership
Total participants, beginning-of-year2020-01-01101
Total number of active participants reported on line 7a of the Form 55002020-01-0175
Number of retired or separated participants receiving benefits2020-01-014
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0179
2019: HEALTH PLAN OF CURATIVE CARE NETWORK 2019 401k membership
Total participants, beginning-of-year2019-01-01114
Total number of active participants reported on line 7a of the Form 55002019-01-01101
Total of all active and inactive participants2019-01-01101
Total participants2019-01-01101
2018: HEALTH PLAN OF CURATIVE CARE NETWORK 2018 401k membership
Total participants, beginning-of-year2018-01-01113
Total number of active participants reported on line 7a of the Form 55002018-01-01114
Total of all active and inactive participants2018-01-01114
Total participants2018-01-01114
2017: HEALTH PLAN OF CURATIVE CARE NETWORK 2017 401k membership
Total participants, beginning-of-year2017-01-01126
Total number of active participants reported on line 7a of the Form 55002017-01-01113
Number of retired or separated participants receiving benefits2017-01-015
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01118
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
Number of employers contributing to the scheme2017-01-010
2016: HEALTH PLAN OF CURATIVE CARE NETWORK 2016 401k membership
Total participants, beginning-of-year2016-01-01111
Total number of active participants reported on line 7a of the Form 55002016-01-01126
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01127
2015: HEALTH PLAN OF CURATIVE CARE NETWORK 2015 401k membership
Total participants, beginning-of-year2015-01-01119
Total number of active participants reported on line 7a of the Form 55002015-01-01110
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01111
Number of participants with account balances2015-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2013: HEALTH PLAN OF CURATIVE CARE NETWORK 2013 401k membership
Total participants, beginning-of-year2013-09-01122
Total number of active participants reported on line 7a of the Form 55002013-09-01121
Number of retired or separated participants receiving benefits2013-09-014
Number of other retired or separated participants entitled to future benefits2013-09-010
Total of all active and inactive participants2013-09-01125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-09-010
Total participants2013-09-01125
Number of participants with account balances2013-09-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-09-010
2012: HEALTH PLAN OF CURATIVE CARE NETWORK 2012 401k membership
Total participants, beginning-of-year2012-09-01122
Total number of active participants reported on line 7a of the Form 55002012-09-01121
Number of retired or separated participants receiving benefits2012-09-011
Total of all active and inactive participants2012-09-01122
Total participants2012-09-01122
2011: HEALTH PLAN OF CURATIVE CARE NETWORK 2011 401k membership
Total participants, beginning-of-year2011-09-01137
Total number of active participants reported on line 7a of the Form 55002011-09-01124
Number of retired or separated participants receiving benefits2011-09-013
Total of all active and inactive participants2011-09-01127
Total participants2011-09-01127
Total participants, beginning-of-year2011-01-01250
Total number of active participants reported on line 7a of the Form 55002011-01-01211
Number of retired or separated participants receiving benefits2011-01-016
Total of all active and inactive participants2011-01-01217
Total participants2011-01-01217
2010: HEALTH PLAN OF CURATIVE CARE NETWORK 2010 401k membership
Total participants, beginning-of-year2010-09-01242
Total number of active participants reported on line 7a of the Form 55002010-09-01211
Number of retired or separated participants receiving benefits2010-09-016
Total of all active and inactive participants2010-09-01217
Total participants2010-09-01217
2009: HEALTH PLAN OF CURATIVE CARE NETWORK 2009 401k membership
Total participants, beginning-of-year2009-09-01254
Total number of active participants reported on line 7a of the Form 55002009-09-01250
Number of retired or separated participants receiving benefits2009-09-018
Total of all active and inactive participants2009-09-01258
Total participants2009-09-01258
Total participants, beginning-of-year2009-01-01238
Total number of active participants reported on line 7a of the Form 55002009-01-01250
Number of retired or separated participants receiving benefits2009-01-016
Total of all active and inactive participants2009-01-01256
Total participants2009-01-01256

Form 5500 Responses for HEALTH PLAN OF CURATIVE CARE NETWORK

2020: HEALTH PLAN OF CURATIVE CARE NETWORK 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: HEALTH PLAN OF CURATIVE CARE NETWORK 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: HEALTH PLAN OF CURATIVE CARE NETWORK 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: HEALTH PLAN OF CURATIVE CARE NETWORK 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: HEALTH PLAN OF CURATIVE CARE NETWORK 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: HEALTH PLAN OF CURATIVE CARE NETWORK 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2013: HEALTH PLAN OF CURATIVE CARE NETWORK 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: HEALTH PLAN OF CURATIVE CARE NETWORK 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedYes
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: HEALTH PLAN OF CURATIVE CARE NETWORK 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedYes
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: HEALTH PLAN OF CURATIVE CARE NETWORK 2010 form 5500 responses
2010-09-01Type of plan entitySingle employer plan
2010-09-01Submission has been amendedYes
2010-09-01This submission is the final filingNo
2010-09-01This return/report is a short plan year return/report (less than 12 months)No
2010-09-01Plan is a collectively bargained planNo
2010-09-01Plan funding arrangement – InsuranceYes
2010-09-01Plan benefit arrangement – InsuranceYes
2009: HEALTH PLAN OF CURATIVE CARE NETWORK 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedYes
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 )
Policy contract number10010413
Policy instance 1
Insurance contract or identification number10010413
Number of Individuals Covered123
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $47,754
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,754
Insurance broker organization code?3
WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 )
Policy contract number10010413
Policy instance 1
Insurance contract or identification number10010413
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $51,818
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,818
Insurance broker organization code?3
WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 )
Policy contract number10010413
Policy instance 1
Insurance contract or identification number10010413
Number of Individuals Covered113
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $49,314
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 $1,410,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,314
Insurance broker organization code?3
Insurance broker nameBENEFIT SERVICES GROUP
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number704868
Policy instance 1
Insurance contract or identification number704868
Number of Individuals Covered184
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $36,446
Are there contracts with allocated funds for individual policies?No
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 $1,004,047
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 fees36446
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
Insurance broker nameBENEFIT SERVICES GROUP
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number704868
Policy instance 1
Insurance contract or identification number704868
Number of Individuals Covered125
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $-54
Total amount of fees paid to insurance companyUSD $44,156
Are there contracts with allocated funds for individual policies?No
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 $1,214,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $-54
Amount paid for insurance broker fees40556
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
Insurance broker nameBENEFIT SERVICES GROUP
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number704868
Policy instance 1
Insurance contract or identification number704868
Number of Individuals Covered188
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $4,111,241
Are there contracts with allocated funds for individual policies?No
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 $1,174,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,112
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number704868
Policy instance 1
Insurance contract or identification number704868
Number of Individuals Covered127
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $42,547
Are there contracts with allocated funds for individual policies?No
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 $1,050,631
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 number704868
Policy instance 1
Insurance contract or identification number704868
Number of Individuals Covered217
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $38,025
Total amount of fees paid to insurance companyUSD $6,781
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $996,132
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 number704868
Policy instance 1
Insurance contract or identification number704868
Number of Individuals Covered217
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $44,806
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $890,964
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 number704868
Policy instance 1
Insurance contract or identification number704868
Number of Individuals Covered250
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $41,119
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,738,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,119
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS INC

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