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UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 401k Plan overview

Plan NameUNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD
Plan identification number 511

UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION, INC. has sponsored the creation of one or more 401k plans.

Company Name:UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION, INC.
Employer identification number (EIN):391824445
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112015-01-01GAIL MIDLIKOWSKI GAIL MIDLIKOWSKI2016-07-26
5112014-01-01GAIL MIDLIKOWSKI
5112013-01-01GAIL MIDLIKOWSKI TERRY BOLZ2014-07-21
5112012-01-01GAIL MIDLIKOWSKI TERRY BOLZ2013-07-29
5112011-01-01GAIL MIDLIKOWSKI TERRY BOLZ2012-07-31
5112010-01-01GAIL MIDLIKOWSKI TERRY BOLZ2011-07-25
5112009-01-01GAIL MIDLIKOWSKI TERRY BOLZ2010-08-13

Plan Statistics for UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD

401k plan membership statisitcs for UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD

Measure Date Value
2015: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2015 401k membership
Total participants, beginning-of-year2015-01-01253
Total number of active participants reported on line 7a of the Form 55002015-01-01327
Total of all active and inactive participants2015-01-01327
Total participants2015-01-01327
2014: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2014 401k membership
Total participants, beginning-of-year2014-01-01217
Total number of active participants reported on line 7a of the Form 55002014-01-01247
Total of all active and inactive participants2014-01-01247
Total participants2014-01-01247
2013: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2013 401k membership
Total participants, beginning-of-year2013-01-01187
Total number of active participants reported on line 7a of the Form 55002013-01-01217
Total of all active and inactive participants2013-01-01217
Total participants2013-01-01217
2012: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2012 401k membership
Total participants, beginning-of-year2012-01-01169
Total number of active participants reported on line 7a of the Form 55002012-01-01187
Total of all active and inactive participants2012-01-01187
Total participants2012-01-01187
2011: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2011 401k membership
Total participants, beginning-of-year2011-01-01159
Total number of active participants reported on line 7a of the Form 55002011-01-01169
Total of all active and inactive participants2011-01-01169
Total participants2011-01-01169
2010: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2010 401k membership
Total participants, beginning-of-year2010-01-01160
Total number of active participants reported on line 7a of the Form 55002010-01-01159
Total of all active and inactive participants2010-01-01159
Total participants2010-01-01159
2009: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2009 401k membership
Total participants, beginning-of-year2009-01-01161
Total number of active participants reported on line 7a of the Form 55002009-01-01160
Total of all active and inactive participants2009-01-01160
Total participants2009-01-01160

Form 5500 Responses for UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD

2015: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 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
2014: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2011 form 5500 responses
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: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: UNITY HEALTH INSURANCE LIFE, AD/D, DEP LIFE, LTD, STD 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
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

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number036143G
Policy instance 1
Insurance contract or identification number036143G
Number of Individuals Covered313
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $25,816
Total amount of fees paid to insurance companyUSD $13,643
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD/D
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 $410,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5013
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $25,816
Insurance broker nameBUCHHOLZ PLANNING CORP
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number036143G
Policy instance 1
Insurance contract or identification number036143G
Number of Individuals Covered247
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $17,161
Total amount of fees paid to insurance companyUSD $8,856
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD & D
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 $273,835
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,160
Amount paid for insurance broker fees6220
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
Insurance broker nameBPC CLIENT SERVICES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number036143G
Policy instance 1
Insurance contract or identification number036143G
Number of Individuals Covered217
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $15,264
Total amount of fees paid to insurance companyUSD $9,195
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $230,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2635
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $15,264
Insurance broker nameBUCHHOLZ PLANNING CORP
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number036143G
Policy instance 1
Insurance contract or identification number036143G
Number of Individuals Covered187
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,020
Total amount of fees paid to insurance companyUSD $5,752
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $143,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,020
Amount paid for insurance broker fees4016
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
Insurance broker nameBPC CLIENT SERVICES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number036143G
Policy instance 1
Insurance contract or identification number036143G
Number of Individuals Covered169
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $10,331
Total amount of fees paid to insurance companyUSD $4,977
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $147,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number036143G
Policy instance 1
Insurance contract or identification number036143G
Number of Individuals Covered159
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $15,637
Total amount of fees paid to insurance companyUSD $5,229
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $109,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,637
Amount paid for insurance broker fees2008
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
Insurance broker nameBPC CLIENT SERVICES

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