WILLIAM PENN UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN
401k plan membership statisitcs for WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN
Measure | Date | Value |
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2022: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 146 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 141 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 141 |
2021: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 138 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 146 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 146 |
2020: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 145 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 138 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
Total of all active and inactive participants | 2020-01-01 | 138 |
2019: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 152 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 145 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
Total of all active and inactive participants | 2019-01-01 | 145 |
2018: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 168 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 152 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 152 |
2017: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 169 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 168 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
Total of all active and inactive participants | 2017-01-01 | 168 |
2016: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 365 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 366 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 366 |
2015: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 288 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 365 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 365 |
2014: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 800 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 288 |
Total of all active and inactive participants | 2014-01-01 | 288 |
Total participants | 2014-01-01 | 0 |
2013: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 299 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 800 |
Total of all active and inactive participants | 2013-01-01 | 800 |
Total participants | 2013-01-01 | 0 |
2012: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 180 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 299 |
Total of all active and inactive participants | 2012-01-01 | 299 |
Total participants | 2012-01-01 | 0 |
2011: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 150 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 180 |
Total of all active and inactive participants | 2011-01-01 | 180 |
Total participants | 2011-01-01 | 180 |
2009: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 157 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 149 |
Total of all active and inactive participants | 2009-01-01 | 149 |
Total participants | 2009-01-01 | 149 |
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
Policy contract number | 00075653 |
Policy instance | 7 |
Insurance contract or identification number | 00075653 | Number of Individuals Covered | 73 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $484,557 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 00075653 |
Policy instance | 1 |
Insurance contract or identification number | 00075653 | Number of Individuals Covered | 41 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,088,193 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 35292 |
Policy instance | 2 |
Insurance contract or identification number | 35292 | Number of Individuals Covered | 141 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,634 | Total amount of fees paid to insurance company | USD $496 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $80,689 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,271 | Amount paid for insurance broker fees | 410 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0BQFM |
Policy instance | 3 |
Insurance contract or identification number | GLTD0BQFM | Number of Individuals Covered | 141 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,614 | Total amount of fees paid to insurance company | USD $2,113 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,427 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,614 | Amount paid for insurance broker fees | 1242 | Additional information about fees paid to insurance broker | OTHER COMPENSATION AGENT/BROKER | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BQFM |
Policy instance | 4 |
Insurance contract or identification number | GLUG0BQFM | Number of Individuals Covered | 141 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,748 | Total amount of fees paid to insurance company | USD $1,415 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $11,655 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,748 | Amount paid for insurance broker fees | 832 | Additional information about fees paid to insurance broker | OTHER COMPENSATION AGENT/BROKER | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG0BQFM |
Policy instance | 5 |
Insurance contract or identification number | GUG0BQFM | Number of Individuals Covered | 141 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,974 | Total amount of fees paid to insurance company | USD $2,407 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,829 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,974 | Amount paid for insurance broker fees | 1416 | Additional information about fees paid to insurance broker | OTHER COMPENSATION AGENT/BROKER | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVLTD0BQFM |
Policy instance | 6 |
Insurance contract or identification number | GVLTD0BQFM | Number of Individuals Covered | 68 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,845 | Total amount of fees paid to insurance company | USD $2,450 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $18,968 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,845 | Amount paid for insurance broker fees | 1502 | Additional information about fees paid to insurance broker | OTHER COMPENSATION AGENT/BROKER | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BQFM |
Policy instance | 4 |
Insurance contract or identification number | GLUG0BQFM | Number of Individuals Covered | 138 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-07-01 | Total amount of commissions paid to insurance broker | USD $1,640 | Total amount of fees paid to insurance company | USD $547 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $10,931 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,640 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 547 |
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WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 00075653 |
Policy instance | 1 |
Insurance contract or identification number | 00075653 | Number of Individuals Covered | 113 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,532,959 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG0BQFM |
Policy instance | 5 |
Insurance contract or identification number | GUG0BQFM | Number of Individuals Covered | 138 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-07-01 | Total amount of commissions paid to insurance broker | USD $2,785 | Total amount of fees paid to insurance company | USD $928 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,565 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,785 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 928 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0BQFM |
Policy instance | 3 |
Insurance contract or identification number | GLTD0BQFM | Number of Individuals Covered | 138 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-07-01 | Total amount of commissions paid to insurance broker | USD $2,443 | Total amount of fees paid to insurance company | USD $814 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,287 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,443 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 814 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVLTD0BQFM |
Policy instance | 6 |
Insurance contract or identification number | GVLTD0BQFM | Number of Individuals Covered | 66 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-07-01 | Total amount of commissions paid to insurance broker | USD $3,010 | Total amount of fees paid to insurance company | USD $1,003 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $20,064 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,010 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1003 |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 35292 |
Policy instance | 2 |
Insurance contract or identification number | 35292 | Number of Individuals Covered | 146 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,668 | Total amount of fees paid to insurance company | USD $248 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $81,510 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,730 | Amount paid for insurance broker fees | 206 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 33145 |
Policy instance | 2 |
Insurance contract or identification number | 33145 | Number of Individuals Covered | 124 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $4,306 | Total amount of fees paid to insurance company | USD $437 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $78,295 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,306 | Amount paid for insurance broker fees | 437 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 335731 |
Policy instance | 5 |
Insurance contract or identification number | 335731 | Number of Individuals Covered | 3173 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-07-01 | Total amount of commissions paid to insurance broker | USD $22,112 | Total amount of fees paid to insurance company | USD $1,974 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $232,530 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,028 | Amount paid for insurance broker fees | 1627 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 631595 |
Policy instance | 3 |
Insurance contract or identification number | 631595 | Number of Individuals Covered | 138 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-07-01 | Total amount of commissions paid to insurance broker | USD $217 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (ADD) | Welfare Benefit Premiums Paid to Carrier | USD $17,304 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $217 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 631596 |
Policy instance | 4 |
Insurance contract or identification number | 631596 | Number of Individuals Covered | 23 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-07-01 | Total amount of commissions paid to insurance broker | USD $83 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (LIFESTYLE ADD) | Welfare Benefit Premiums Paid to Carrier | USD $6,672 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $83 |
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WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 0000800710007 |
Policy instance | 1 |
Insurance contract or identification number | 0000800710007 | Number of Individuals Covered | 105 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 0000800710007 |
Policy instance | 1 |
Insurance contract or identification number | 0000800710007 | Number of Individuals Covered | 112 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 335731 |
Policy instance | 4 |
Insurance contract or identification number | 335731 | Number of Individuals Covered | 143 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,404 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 33145 |
Policy instance | 2 |
Insurance contract or identification number | 33145 | Number of Individuals Covered | 127 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,398 | Total amount of fees paid to insurance company | USD $481 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,960 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,398 | Amount paid for insurance broker fees | 481 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 631595 |
Policy instance | 3 |
Insurance contract or identification number | 631595 | Number of Individuals Covered | 145 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $230 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (ADD) | Welfare Benefit Premiums Paid to Carrier | USD $18,412 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $230 | Insurance broker organization code? | 3 |
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WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 0000800710007 |
Policy instance | 1 |
Insurance contract or identification number | 0000800710007 | Number of Individuals Covered | 116 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $24,888 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,888 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 33145 |
Policy instance | 2 |
Insurance contract or identification number | 33145 | Number of Individuals Covered | 134 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $4,843 | Total amount of fees paid to insurance company | USD $599 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $88,120 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,843 | Amount paid for insurance broker fees | 599 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS (IC) |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 335731 |
Policy instance | 4 |
Insurance contract or identification number | 335731 | Number of Individuals Covered | 155 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,249 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker name | MERCER HELATH & BENEFITS - URB |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 631595 |
Policy instance | 5 |
Insurance contract or identification number | 631595 | Number of Individuals Covered | 168 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $354 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (ADD) | Welfare Benefit Premiums Paid to Carrier | USD $28,309 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $354 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS - URB |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 631596-0001 |
Policy instance | 3 |
Insurance contract or identification number | 631596-0001 | Number of Individuals Covered | 45 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $176 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY)ADD | Welfare Benefit Premiums Paid to Carrier | USD $14,095 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $176 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS - URB |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 631596-0001 |
Policy instance | 5 |
Insurance contract or identification number | 631596-0001 | Number of Individuals Covered | 42 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY)ADD | Welfare Benefit Premiums Paid to Carrier | USD $4,799 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS - URB |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 335731-0122 |
Policy instance | 4 |
Insurance contract or identification number | 335731-0122 | Number of Individuals Covered | 163 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of fees paid to insurance company | USD $110 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,832 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 110 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS - URB |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 687 |
Policy instance | 3 |
Insurance contract or identification number | 687 | Number of Individuals Covered | 365 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $23,293 | Total amount of fees paid to insurance company | USD $535 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $423,505 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,293 | Amount paid for insurance broker fees | 535 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS (IC) |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 631595 |
Policy instance | 2 |
Insurance contract or identification number | 631595 | Number of Individuals Covered | 158 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2015-12-31 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY)ACCIDENTAL DEATH & D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker name | MERCER HEALTH & BENEFITS -URB |
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WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 0000800710007 |
Policy instance | 1 |
Insurance contract or identification number | 0000800710007 | Number of Individuals Covered | 122 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $24,486 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY)DRUG | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,486 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS |
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WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 000800710007 |
Policy instance | 1 |
Insurance contract or identification number | 000800710007 | Number of Individuals Covered | 288 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | DRUG | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
Policy contract number | GL-0706 |
Policy instance | 2 |
Insurance contract or identification number | GL-0706 | Number of Individuals Covered | 168 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $3,076 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,076 | Insurance broker organization code? | 3 | Insurance broker name | KIRBY P MOSS |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 687 |
Policy instance | 3 |
Insurance contract or identification number | 687 | Number of Individuals Covered | 138 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $4,854 | Total amount of fees paid to insurance company | USD $570 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $88,258 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,854 | Amount paid for insurance broker fees | 570 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH BENEFITS |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 4 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 166 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $3,707 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $27,727 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,707 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT ADVISORS INC.DBA ACUMEN |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 5 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 166 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $4,407 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,962 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,407 | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT ADVISORS INC.DBA ACUMEN |
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WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 000800710007 |
Policy instance | 1 |
Insurance contract or identification number | 000800710007 | Number of Individuals Covered | 298 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | DRUG | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 5 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 174 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,647 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,398 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,647 | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT ADVISORS INCD DBA ACUMEN |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 687 |
Policy instance | 3 |
Insurance contract or identification number | 687 | Number of Individuals Covered | 151 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,910 | Total amount of fees paid to insurance company | USD $562 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $89,263 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,910 | Amount paid for insurance broker fees | 562 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH BENEFITS |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 4 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 174 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,652 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,344 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,652 | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT ADVISORS INCD DBA ACUMEN |
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EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
Policy contract number | GL-0706 |
Policy instance | 2 |
Insurance contract or identification number | GL-0706 | Number of Individuals Covered | 177 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,346 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,346 | Insurance broker organization code? | 3 | Insurance broker name | KIRBY P MOSS |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 2 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 179 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,028 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,185 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,028 | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT SOLUTIONS INC |
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WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 000800710007 |
Policy instance | 5 |
Insurance contract or identification number | 000800710007 | Number of Individuals Covered | 144 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | DRUG | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
Policy contract number | GL-0706 |
Policy instance | 4 |
Insurance contract or identification number | GL-0706 | Number of Individuals Covered | 180 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $2,901 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,901 | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT ADVISORS INC. |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 687 |
Policy instance | 3 |
Insurance contract or identification number | 687 | Number of Individuals Covered | 155 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,943 | Total amount of fees paid to insurance company | USD $481 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $89,866 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,943 | Amount paid for insurance broker fees | 481 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH BENEFITS |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 1 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 179 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,729 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,071 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,729 | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT SOLUTIONS INC |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 1 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 179 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $3,453 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $28,775 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 000800710007 |
Policy instance | 5 |
Insurance contract or identification number | 000800710007 | Number of Individuals Covered | 148 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | DRUG | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
Policy contract number | GL-0706 |
Policy instance | 4 |
Insurance contract or identification number | GL-0706 | Number of Individuals Covered | 180 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $3,559 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 687 |
Policy instance | 3 |
Insurance contract or identification number | 687 | Number of Individuals Covered | 156 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,727 | Total amount of fees paid to insurance company | USD $591 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $85,942 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 2 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 179 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $2,849 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,995 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 1 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 182 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $2,652 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,095 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,652 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT SOLUTIONS INC |
|
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
Policy contract number | 000800710007 |
Policy instance | 5 |
Insurance contract or identification number | 000800710007 | Number of Individuals Covered | 150 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
Policy contract number | GL-0706 |
Policy instance | 4 |
Insurance contract or identification number | GL-0706 | Number of Individuals Covered | 182 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,430 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,430 | Additional information about fees paid to insurance broker | COMMISSIONS PAID | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT SOLUTIONS INC |
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DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
Policy contract number | 687 |
Policy instance | 3 |
Insurance contract or identification number | 687 | Number of Individuals Covered | 157 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $4,284 | Total amount of fees paid to insurance company | USD $521 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $77,896 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,284 | Amount paid for insurance broker fees | 521 | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH BENEFITS |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53282 |
Policy instance | 2 |
Insurance contract or identification number | 53282 | Number of Individuals Covered | 182 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $2,586 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,586 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT SOLUTIONS INC |
|