I & M MACHINE FABRICATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN
401k plan membership statisitcs for I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN
Measure | Date | Value |
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2022: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-03-01 | 106 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-03-01 | 125 |
Number of retired or separated participants receiving benefits | 2022-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-03-01 | 0 |
Total of all active and inactive participants | 2022-03-01 | 125 |
Number of employers contributing to the scheme | 2022-03-01 | 0 |
2021: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-03-01 | 112 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-03-01 | 106 |
Number of retired or separated participants receiving benefits | 2021-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-03-01 | 0 |
Total of all active and inactive participants | 2021-03-01 | 106 |
Number of employers contributing to the scheme | 2021-03-01 | 0 |
2020: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-03-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 112 |
Number of retired or separated participants receiving benefits | 2020-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-03-01 | 0 |
Total of all active and inactive participants | 2020-03-01 | 112 |
Number of employers contributing to the scheme | 2020-03-01 | 0 |
2019: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-03-01 | 124 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 123 |
Number of retired or separated participants receiving benefits | 2019-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-03-01 | 0 |
Total of all active and inactive participants | 2019-03-01 | 123 |
Number of employers contributing to the scheme | 2019-03-01 | 0 |
2018: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-03-01 | 106 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 123 |
Number of retired or separated participants receiving benefits | 2018-03-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2018-03-01 | 0 |
Total of all active and inactive participants | 2018-03-01 | 124 |
2017: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-03-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 105 |
Number of retired or separated participants receiving benefits | 2017-03-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2017-03-01 | 0 |
Total of all active and inactive participants | 2017-03-01 | 106 |
2016: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-03-01 | 150 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 146 |
Number of retired or separated participants receiving benefits | 2016-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-03-01 | 0 |
Total of all active and inactive participants | 2016-03-01 | 146 |
2015: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-03-01 | 108 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 101 |
Number of retired or separated participants receiving benefits | 2015-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-03-01 | 0 |
Total of all active and inactive participants | 2015-03-01 | 101 |
2022: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2022 form 5500 responses |
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2022-03-01 | Type of plan entity | Single employer plan |
2022-03-01 | Plan funding arrangement – Insurance | Yes |
2022-03-01 | Plan benefit arrangement – Insurance | Yes |
2021: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2021 form 5500 responses |
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2021-03-01 | Type of plan entity | Single employer plan |
2021-03-01 | Plan funding arrangement – Insurance | Yes |
2021-03-01 | Plan benefit arrangement – Insurance | Yes |
2020: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2020 form 5500 responses |
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2020-03-01 | Type of plan entity | Single employer plan |
2020-03-01 | Plan funding arrangement – Insurance | Yes |
2020-03-01 | Plan benefit arrangement – Insurance | Yes |
2019: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2019 form 5500 responses |
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2019-03-01 | Type of plan entity | Single employer plan |
2019-03-01 | Plan funding arrangement – Insurance | Yes |
2019-03-01 | Plan benefit arrangement – Insurance | Yes |
2018: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2018 form 5500 responses |
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2018-03-01 | Type of plan entity | Single employer plan |
2018-03-01 | Submission has been amended | No |
2018-03-01 | This submission is the final filing | No |
2018-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-03-01 | Plan is a collectively bargained plan | No |
2018-03-01 | Plan funding arrangement – Insurance | Yes |
2018-03-01 | Plan benefit arrangement – Insurance | Yes |
2017: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2017 form 5500 responses |
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2017-03-01 | Type of plan entity | Single employer plan |
2017-03-01 | Submission has been amended | No |
2017-03-01 | This submission is the final filing | No |
2017-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-03-01 | Plan is a collectively bargained plan | No |
2017-03-01 | Plan funding arrangement – Insurance | Yes |
2017-03-01 | Plan benefit arrangement – Insurance | Yes |
2016: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2016 form 5500 responses |
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2016-03-01 | Type of plan entity | Single employer plan |
2016-03-01 | Submission has been amended | No |
2016-03-01 | This submission is the final filing | No |
2016-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-03-01 | Plan is a collectively bargained plan | No |
2016-03-01 | Plan funding arrangement – Insurance | Yes |
2016-03-01 | Plan benefit arrangement – Insurance | Yes |
2015: I & M MACHINE FABRICATION EMPLOYEE BENEFITS PLAN 2015 form 5500 responses |
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2015-03-01 | Type of plan entity | Single employer plan |
2015-03-01 | Submission has been amended | No |
2015-03-01 | This submission is the final filing | No |
2015-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-03-01 | Plan is a collectively bargained plan | No |
2015-03-01 | Plan funding arrangement – Insurance | Yes |
2015-03-01 | Plan benefit arrangement – Insurance | Yes |
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 629463 |
Policy instance | 2 |
Insurance contract or identification number | 629463 | Number of Individuals Covered | 115 | Insurance policy start date | 2021-04-01 | Insurance policy end date | 2022-03-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $27,470 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $863,398 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 27470 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES, INCENTIVE COMPENSATION | Insurance broker organization code? | 3 |
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UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 549317 |
Policy instance | 1 |
Insurance contract or identification number | 549317 | Number of Individuals Covered | 125 | Insurance policy start date | 2022-03-01 | Insurance policy end date | 2023-02-28 | Total amount of commissions paid to insurance broker | USD $6,369 | Total amount of fees paid to insurance company | USD $1,899 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $61,202 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,369 | Amount paid for insurance broker fees | 1899 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 629463 |
Policy instance | 2 |
Insurance contract or identification number | 629463 | Number of Individuals Covered | 115 | Insurance policy start date | 2020-04-01 | Insurance policy end date | 2021-03-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $19,571 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $863,398 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 19571 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 549317 |
Policy instance | 1 |
Insurance contract or identification number | 549317 | Number of Individuals Covered | 106 | Insurance policy start date | 2021-03-01 | Insurance policy end date | 2022-02-28 | Total amount of commissions paid to insurance broker | USD $6,210 | Total amount of fees paid to insurance company | USD $2,118 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $60,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,210 | Amount paid for insurance broker fees | 2118 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 40396000 |
Policy instance | 2 |
Insurance contract or identification number | 40396000 | Number of Individuals Covered | 174 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2020-03-31 | Total amount of commissions paid to insurance broker | USD $3,489 | Total amount of fees paid to insurance company | USD $1,346 | 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 $3,489 | Amount paid for insurance broker fees | 1346 | Additional information about fees paid to insurance broker | PROVISION OF ADMINISTRATIVE SERVICES TO BCBSKC | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 549317 |
Policy instance | 1 |
Insurance contract or identification number | 549317 | Number of Individuals Covered | 112 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $6,817 | Total amount of fees paid to insurance company | USD $3,963 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $71,601 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,817 | Amount paid for insurance broker fees | 3963 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 40396000 |
Policy instance | 1 |
Insurance contract or identification number | 40396000 | Number of Individuals Covered | 175 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $98,219 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,098,251 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $98,219 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 549317 |
Policy instance | 2 |
Insurance contract or identification number | 549317 | Number of Individuals Covered | 123 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $428 | Total amount of fees paid to insurance company | USD $1,664 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $70,406 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $428 | Amount paid for insurance broker fees | 1664 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1034585 |
Policy instance | 3 |
Insurance contract or identification number | 1034585 | Number of Individuals Covered | 170 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $2,646 | Total amount of fees paid to insurance company | USD $972 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $17,730 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,844 | Amount paid for insurance broker fees | 972 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00549317 |
Policy instance | 2 |
Insurance contract or identification number | 00549317 | Number of Individuals Covered | 122 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $5,355 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $54,011 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,355 | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 40396000 |
Policy instance | 1 |
Insurance contract or identification number | 40396000 | Number of Individuals Covered | 144 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $33,983 | Total amount of fees paid to insurance company | USD $9,978 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Broker | USD $33,983 | Amount paid for insurance broker fees | 9978 | Additional information about fees paid to insurance broker | PROVISION OF ADMINISTRATIVE SERVICES TO BCBSKC | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1034585 |
Policy instance | 3 |
Insurance contract or identification number | 1034585 | Number of Individuals Covered | 171 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $10,092 | Total amount of fees paid to insurance company | USD $945 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $71,986 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,850 | Amount paid for insurance broker fees | 945 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | BLUE CROSS AND BLUE SHIELD OF KC |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9781402 |
Policy instance | 2 |
Insurance contract or identification number | 9781402 | Number of Individuals Covered | 0 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $71 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $71 | Insurance broker organization code? | 3 | Insurance broker name | TRUSS, LLC |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 40396000 |
Policy instance | 1 |
Insurance contract or identification number | 40396000 | Number of Individuals Covered | 149 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $29,779 | Total amount of fees paid to insurance company | USD $9,193 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | Yes | 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 Broker | USD $29,779 | Amount paid for insurance broker fees | 9193 | Additional information about fees paid to insurance broker | PROVISION OF ADMINISTRATIVE SERVICES TO BCBSKC | Insurance broker organization code? | 3 | Insurance broker name | TRUSS, LLC |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1034585 |
Policy instance | 3 |
Insurance contract or identification number | 1034585 | Number of Individuals Covered | 167 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $5,651 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $57,550 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,257 | Insurance broker organization code? | 3 | Insurance broker name | TRUSS, LLC |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9781402 |
Policy instance | 2 |
Insurance contract or identification number | 9781402 | Number of Individuals Covered | 139 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $793 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $7,966 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $793 | Insurance broker organization code? | 3 | Insurance broker name | POWER GROUP COMPANY LLC |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 5052800000 |
Policy instance | 1 |
Insurance contract or identification number | 5052800000 | Number of Individuals Covered | 150 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $31,856 | Total amount of fees paid to insurance company | USD $1,688 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $796,401 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,856 | Amount paid for insurance broker fees | 1688 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | POWER GROUP COMPANY LLC |
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