NORTH AMERICAN SAVINGS BANK, F.S.B. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES
401k plan membership statisitcs for NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES
| Measure | Date | Value |
|---|
| 2022: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 657 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 435 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 15 |
| 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 | 450 |
| 2021: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 636 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 654 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 4 |
| 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 | 658 |
| 2020: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 369 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 634 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 4 |
| 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 | 638 |
| 2019: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 341 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 364 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 3 |
| 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 | 367 |
| 2018: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-10-01 | 352 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 339 |
| Number of retired or separated participants receiving benefits | 2018-10-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2018-10-01 | 0 |
| Total of all active and inactive participants | 2018-10-01 | 341 |
| 2017: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 361 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 347 |
| Number of retired or separated participants receiving benefits | 2017-10-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
| Total of all active and inactive participants | 2017-10-01 | 352 |
| 2016: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 387 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 352 |
| Number of retired or separated participants receiving benefits | 2016-10-01 | 10 |
| Number of other retired or separated participants entitled to future benefits | 2016-10-01 | 0 |
| Total of all active and inactive participants | 2016-10-01 | 362 |
| 2014: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 385 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 409 |
| Number of retired or separated participants receiving benefits | 2014-10-01 | 6 |
| Number of other retired or separated participants entitled to future benefits | 2014-10-01 | 0 |
| Total of all active and inactive participants | 2014-10-01 | 415 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-10-01 | 0 |
| Total participants | 2014-10-01 | 415 |
| Number of participants with account balances | 2014-10-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-10-01 | 0 |
| 2013: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 451 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 385 |
| Number of retired or separated participants receiving benefits | 2013-10-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2013-10-01 | 0 |
| Total of all active and inactive participants | 2013-10-01 | 388 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-10-01 | 0 |
| Total participants | 2013-10-01 | 388 |
| 2012: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 401 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 451 |
| Number of retired or separated participants receiving benefits | 2012-10-01 | 6 |
| Total of all active and inactive participants | 2012-10-01 | 457 |
| Total participants | 2012-10-01 | 457 |
| 2011: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 370 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 401 |
| Number of retired or separated participants receiving benefits | 2011-10-01 | 3 |
| Total of all active and inactive participants | 2011-10-01 | 404 |
| Total participants | 2011-10-01 | 404 |
| 2009: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 350 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 382 |
| Number of retired or separated participants receiving benefits | 2009-10-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2009-10-01 | 0 |
| Total of all active and inactive participants | 2009-10-01 | 385 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-10-01 | 1 |
| Total participants | 2009-10-01 | 386 |
| 2008: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-10-01 | 305 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-10-01 | 350 |
| Number of retired or separated participants receiving benefits | 2008-10-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2008-10-01 | 0 |
| Total of all active and inactive participants | 2008-10-01 | 352 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2008-10-01 | 0 |
| Total participants | 2008-10-01 | 352 |
| 2022: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2018 form 5500 responses |
|---|
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | First time form 5500 has been submitted | Yes |
| 2014-10-01 | Submission has been amended | No |
| 2014-10-01 | This submission is the final filing | No |
| 2014-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-10-01 | Plan is a collectively bargained plan | No |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Single employer plan |
| 2013-10-01 | First time form 5500 has been submitted | Yes |
| 2013-10-01 | Submission has been amended | No |
| 2013-10-01 | This submission is the final filing | No |
| 2013-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-10-01 | Plan is a collectively bargained plan | No |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | First time form 5500 has been submitted | Yes |
| 2012-10-01 | Submission has been amended | No |
| 2012-10-01 | This submission is the final filing | No |
| 2012-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-10-01 | Plan is a collectively bargained plan | No |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | First time form 5500 has been submitted | Yes |
| 2011-10-01 | Submission has been amended | No |
| 2011-10-01 | This submission is the final filing | No |
| 2011-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-10-01 | Plan is a collectively bargained plan | No |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | First time form 5500 has been submitted | Yes |
| 2009-10-01 | Submission has been amended | No |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-10-01 | Plan is a collectively bargained plan | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: NORTH AMERICAN SAVINGS BANK FLEXIBLE BENEFIT PLAN FOR EMPLOYEES 2008 form 5500 responses |
|---|
| 2008-10-01 | Type of plan entity | Single employer plan |
| 2008-10-01 | First time form 5500 has been submitted | Yes |
| 2008-10-01 | Submission has been amended | No |
| 2008-10-01 | This submission is the final filing | No |
| 2008-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-10-01 | Plan is a collectively bargained plan | No |
| 2008-10-01 | Plan funding arrangement – Insurance | Yes |
| 2008-10-01 | Plan benefit arrangement – Insurance | Yes |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VHI000192 |
| Policy instance | 7 |
| Insurance contract or identification number | VHI000192 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $9,101 | | Other welfare benefits provided | HOSPITAL INDEMNITY | | Welfare Benefit Premiums Paid to Carrier | USD $36,405 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,461 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 35452000 |
| Policy instance | 1 |
| Insurance contract or identification number | 35452000 | | Number of Individuals Covered | 786 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $62,220 | | Total amount of fees paid to insurance company | USD $117,544 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,160,407 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $62,220 | | Amount paid for insurance broker fees | 117544 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES OTHER NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 497370 |
| Policy instance | 2 |
| Insurance contract or identification number | 497370 | | Number of Individuals Covered | 435 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $22,400 | | Total amount of fees paid to insurance company | USD $23,343 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EAP, AND AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $369,235 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,400 | | Amount paid for insurance broker fees | 5565 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10074691001 |
| Policy instance | 3 |
| Insurance contract or identification number | 10074691001 | | Number of Individuals Covered | 724 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $5,742 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,997 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,742 | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340092 |
| Policy instance | 4 |
| Insurance contract or identification number | 3340092 | | Number of Individuals Covered | 343 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $12,690 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $320,848 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,690 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAI 826797 |
| Policy instance | 5 |
| Insurance contract or identification number | VAI 826797 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $10,748 | | Total amount of fees paid to insurance company | USD $477 | | Other welfare benefits provided | VOLUNTARY ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $34,671 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,414 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 477 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VCI 802084 |
| Policy instance | 6 |
| Insurance contract or identification number | VCI 802084 | | Number of Individuals Covered | 304 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $18,964 | | Total amount of fees paid to insurance company | USD $764 | | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $61,174 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,317 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 764 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 35452000 |
| Policy instance | 1 |
| Insurance contract or identification number | 35452000 | | Number of Individuals Covered | 1093 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $76,762 | | Total amount of fees paid to insurance company | USD $131,525 | | 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 $76,762 | | Amount paid for insurance broker fees | 131525 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 497370 |
| Policy instance | 2 |
| Insurance contract or identification number | 497370 | | Number of Individuals Covered | 654 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $24,886 | | Total amount of fees paid to insurance company | USD $33,218 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EAP, AND AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $420,040 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,886 | | Amount paid for insurance broker fees | 15629 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10074691001 |
| Policy instance | 3 |
| Insurance contract or identification number | 10074691001 | | Number of Individuals Covered | 960 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $6,934 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,496 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,934 | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340092 |
| Policy instance | 4 |
| Insurance contract or identification number | 3340092 | | Number of Individuals Covered | 516 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $14,084 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $356,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,084 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAI 826797 |
| Policy instance | 5 |
| Insurance contract or identification number | VAI 826797 | | Number of Individuals Covered | 163 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $10,761 | | Total amount of fees paid to insurance company | USD $473 | | Other welfare benefits provided | VOLUNTARY ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $34,715 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,422 | | Amount paid for insurance broker fees | 251 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VCI 802084 |
| Policy instance | 6 |
| Insurance contract or identification number | VCI 802084 | | Number of Individuals Covered | 229 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $17,233 | | Total amount of fees paid to insurance company | USD $1,616 | | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $55,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,949 | | Amount paid for insurance broker fees | 822 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VHI000192 |
| Policy instance | 7 |
| Insurance contract or identification number | VHI000192 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $8,580 | | Other welfare benefits provided | HOSPITAL INDEMNITY | | Welfare Benefit Premiums Paid to Carrier | USD $34,320 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,148 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VHI000192 |
| Policy instance | 9 |
| Insurance contract or identification number | VHI000192 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $7,155 | | Other welfare benefits provided | HOSPITAL INDEMNITY | | Welfare Benefit Premiums Paid to Carrier | USD $27,379 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,116 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAI 826797 |
| Policy instance | 7 |
| Insurance contract or identification number | VAI 826797 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $9,291 | | Total amount of fees paid to insurance company | USD $1,286 | | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $28,125 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,489 | | Amount paid for insurance broker fees | 627 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAI 826797 |
| Policy instance | 6 |
| Insurance contract or identification number | VAI 826797 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $9,291 | | Total amount of fees paid to insurance company | USD $1,286 | | Other welfare benefits provided | VOLUNTARY ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $28,125 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,489 | | Amount paid for insurance broker fees | 627 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES | | Insurance broker organization code? | 3 |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 002746 |
| Policy instance | 5 |
| Insurance contract or identification number | 002746 | | Number of Individuals Covered | 645 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $7,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340092 |
| Policy instance | 4 |
| Insurance contract or identification number | 3340092 | | Number of Individuals Covered | 466 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $9,856 | | Total amount of fees paid to insurance company | USD $2,025 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $249,552 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,856 | | Amount paid for insurance broker fees | 2025 | | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10074691001 |
| Policy instance | 3 |
| Insurance contract or identification number | 10074691001 | | Number of Individuals Covered | 850 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $4,923 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,268 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,923 | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 07768 |
| Policy instance | 2 |
| Insurance contract or identification number | 07768 | | Number of Individuals Covered | 813 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $19,582 | | Total amount of fees paid to insurance company | USD $119 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $313,987 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,692 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 14 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 35452000 |
| Policy instance | 1 |
| Insurance contract or identification number | 35452000 | | Number of Individuals Covered | 985 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $78,816 | | Total amount of fees paid to insurance company | USD $90,075 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,503,757 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $78,816 | | Amount paid for insurance broker fees | 90075 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VCI 802084 |
| Policy instance | 8 |
| Insurance contract or identification number | VCI 802084 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $18,851 | | Total amount of fees paid to insurance company | USD $293 | | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $36,991 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,535 | | Amount paid for insurance broker fees | 143 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VCI 801666 |
| Policy instance | 8 |
| Insurance contract or identification number | VCI 801666 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $13,995 | | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $24,991 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,747 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAI 826797 |
| Policy instance | 7 |
| Insurance contract or identification number | VAI 826797 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $16,305 | | Other welfare benefits provided | VOLUNTARY ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $25,088 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,033 | | Insurance broker organization code? | 3 |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 002746 |
| Policy instance | 6 |
| Insurance contract or identification number | 002746 | | Number of Individuals Covered | 492 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $6,108 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340092 |
| Policy instance | 5 |
| Insurance contract or identification number | 3340092 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $8,915 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $225,904 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,915 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10074691001 |
| Policy instance | 4 |
| Insurance contract or identification number | 10074691001 | | Number of Individuals Covered | 650 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $4,116 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,375 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,116 | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 07768 |
| Policy instance | 3 |
| Insurance contract or identification number | 07768 | | Number of Individuals Covered | 479 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $152,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 07768 |
| Policy instance | 2 |
| Insurance contract or identification number | 07768 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $15,063 | | Total amount of fees paid to insurance company | USD $168 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $96,610 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,792 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 168 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VCI 802084 |
| Policy instance | 9 |
| Insurance contract or identification number | VCI 802084 | | Number of Individuals Covered | 166 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $3,199 | | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $5,711 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,771 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VHI000192 |
| Policy instance | 10 |
| Insurance contract or identification number | VHI000192 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $4,874 | | Other welfare benefits provided | HOSPITAL INDEMNITY | | Welfare Benefit Premiums Paid to Carrier | USD $19,493 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,924 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 35452000 |
| Policy instance | 1 |
| Insurance contract or identification number | 35452000 | | Number of Individuals Covered | 817 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $73,490 | | Total amount of fees paid to insurance company | USD $82,755 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,128,663 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $73,490 | | Amount paid for insurance broker fees | 82755 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES NON-MONETARY COMPENSAITON | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 07768 |
| Policy instance | 2 |
| Insurance contract or identification number | 07768 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $12,938 | | Total amount of fees paid to insurance company | USD $188 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $87,897 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 07768 |
| Policy instance | 3 |
| Insurance contract or identification number | 07768 | | Number of Individuals Covered | 447 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $68,151 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 601129 |
| Policy instance | 4 |
| Insurance contract or identification number | 601129 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $11,167 | | Total amount of fees paid to insurance company | USD $893 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,668 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0550574 |
| Policy instance | 5 |
| Insurance contract or identification number | R0550574 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $5,460 | | Total amount of fees paid to insurance company | USD $301 | | Other welfare benefits provided | GCIEE, GRPACCVO, GRPHSPVO | | Welfare Benefit Premiums Paid to Carrier | USD $61,179 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10074691001 |
| Policy instance | 6 |
| Insurance contract or identification number | 10074691001 | | Number of Individuals Covered | 548 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $3,879 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,500 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340092 |
| Policy instance | 7 |
| Insurance contract or identification number | 3340092 | | Number of Individuals Covered | 348 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $7,953 | | Total amount of fees paid to insurance company | USD $2,658 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $201,778 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 002746 |
| Policy instance | 8 |
| Insurance contract or identification number | 002746 | | Number of Individuals Covered | 473 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $6,429 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 35452000 |
| Policy instance | 1 |
| Insurance contract or identification number | 35452000 | | Number of Individuals Covered | 755 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $98,629 | | Total amount of fees paid to insurance company | USD $81,122 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,042,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
