HLTC, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC.
401k plan membership statisitcs for GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC.
| Measure | Date | Value |
|---|
| 2015: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 425 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 369 |
| 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 | 5 |
| Total of all active and inactive participants | 2015-01-01 | 374 |
| 2014: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 374 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 314 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 110 |
| Total of all active and inactive participants | 2014-01-01 | 425 |
| Total participants | 2014-01-01 | 0 |
| 2013: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 355 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 284 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 89 |
| Total of all active and inactive participants | 2013-01-01 | 374 |
| Total participants | 2013-01-01 | 0 |
| 2012: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 338 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 275 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 78 |
| Total of all active and inactive participants | 2012-01-01 | 355 |
| Total participants | 2012-01-01 | 0 |
| 2011: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 342 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 321 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 16 |
| Total of all active and inactive participants | 2011-01-01 | 338 |
| Total participants | 2011-01-01 | 338 |
| 2009: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 291 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 298 |
| Total of all active and inactive participants | 2009-01-01 | 298 |
| Total participants | 2009-01-01 | 298 |
| 2015: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | Yes |
| 2015-01-01 | This submission is the final filing | Yes |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: GROUP HEALTH AND DENTAL INSURANCE FOR EMPLOYEES OF HLTC, INC. 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 2HLTC807 |
| Policy instance | 5 |
| Insurance contract or identification number | 2HLTC807 | | Number of Individuals Covered | 222 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $5,603 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $74,895 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,603 | | Insurance broker organization code? | 3 | | Insurance broker name | FORESTER BENEFITS MANAGEMENT, LLC |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 126207 |
| Policy instance | 4 |
| Insurance contract or identification number | LTD 126207 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $78 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $522 | | 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 | | Insurance broker organization code? | 3 | | Insurance broker name | THE BENEFIT COMPANY, INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 154120 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 154120 | | Number of Individuals Covered | 318 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $896 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC.DEATH/DISMEMBER.,DEP LIFE/AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $5,971 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $896 | | Insurance broker organization code? | 3 | | Insurance broker name | THE BENEFIT COMPANY, INC |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-350686 |
| Policy instance | 2 |
| Insurance contract or identification number | 010-350686 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $2,176 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,761 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,176 | | Insurance broker organization code? | 3 | | Insurance broker name | FORESTER BENEFITS MANAGEMENT LLC |
|
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) |
| Policy contract number | A0637 - A0641 |
| Policy instance | 1 |
| Insurance contract or identification number | A0637 - A0641 | | Number of Individuals Covered | 317 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $38,879 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,943,965 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $38,879 | | Insurance broker organization code? | 3 | | Insurance broker name | BENESERVE & ASSOCIATES, LLC |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 154120 |
| Policy instance | 4 |
| Insurance contract or identification number | GL 154120 | | Number of Individuals Covered | 314 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $971 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH/DISMEMBER, DEP LIFE/AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $6,474 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $971 | | Insurance broker organization code? | 3 | | Insurance broker name | THE BENEFIT COMPANY, INC. |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-350686 |
| Policy instance | 3 |
| Insurance contract or identification number | 010-350686 | | Number of Individuals Covered | 279 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $2,485 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,567 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,485 | | Insurance broker organization code? | 3 | | Insurance broker name | FORESTER BENEFITS MANAGEMENT, LLC |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 2HLTC807 |
| Policy instance | 2 |
| Insurance contract or identification number | 2HLTC807 | | Number of Individuals Covered | 199 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $5,656 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $76,792 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,656 | | Insurance broker organization code? | 3 | | Insurance broker name | FORESTER BENEFITS MANAGEMENT, LLC |
|
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) |
| Policy contract number | A0637 / A0641 |
| Policy instance | 1 |
| Insurance contract or identification number | A0637 / A0641 | | Number of Individuals Covered | 292 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $45,557 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,886,602 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,557 | | Insurance broker organization code? | 3 | | Insurance broker name | BENESERVE & ASSOCIATES, LLC |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 126207 |
| Policy instance | 5 |
| Insurance contract or identification number | LTD 126207 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $86 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $571 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $86 | | Insurance broker organization code? | 3 | | Insurance broker name | THE BENEFIT COMPANY, INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 122653 |
| Policy instance | 5 |
| Insurance contract or identification number | LTD 122653 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $173 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,153 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $173 | | Insurance broker organization code? | 3 | | Insurance broker name | THE BENEFIT COMPANY, INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 149348 |
| Policy instance | 4 |
| Insurance contract or identification number | GL 149348 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,015 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | DEPENDENT LIFE, AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $6,765 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,015 | | Insurance broker organization code? | 3 | | Insurance broker name | THE BENEFIT COMPANY, INC. |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-350686 |
| Policy instance | 3 |
| Insurance contract or identification number | 010-350686 | | Number of Individuals Covered | 266 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $2,790 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,600 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,790 | | Insurance broker organization code? | 3 | | Insurance broker name | FORESTER BENEFITS MANAGEMENT, LLC |
|
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) |
| Policy contract number | A0637 / A0641 |
| Policy instance | 1 |
| Insurance contract or identification number | A0637 / A0641 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $50,738 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,691,271 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,738 | | Insurance broker organization code? | 3 | | Insurance broker name | BENESERVE & ASSOCIATES, LLC |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 2HLTC807 |
| Policy instance | 2 |
| Insurance contract or identification number | 2HLTC807 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $5,372 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $67,093 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,372 | | Insurance broker organization code? | 3 | | Insurance broker name | FORESTER BENEFITS MANAGEMENT, LLC |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 122653 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD 122653 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $111 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $741 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $111 | | Insurance broker name | THE BENEFIT COMPANY, INC. |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 2HLTC807 |
| Policy instance | 4 |
| Insurance contract or identification number | 2HLTC807 | | Number of Individuals Covered | 187 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,472 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,895 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,472 | | Insurance broker organization code? | 3 | | Insurance broker name | FORESTER BENEFITS MANAGEMENT, LLC |
|
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) |
| Policy contract number | A0637 |
| Policy instance | 5 |
| Insurance contract or identification number | A0637 | | Number of Individuals Covered | 275 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $37,126 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,670,858 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,126 | | Insurance broker organization code? | 3 | | Insurance broker name | BENESERVE & ASSOCIATES |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-350686 |
| Policy instance | 3 |
| Insurance contract or identification number | 010-350686 | | Number of Individuals Covered | 255 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $2,939 | | Total amount of fees paid to insurance company | USD $379 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,925 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,939 | | Amount paid for insurance broker fees | 379 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Insurance broker name | FORESTER BENEFITS MANAGEMENT, LLC |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 149348 |
| Policy instance | 2 |
| Insurance contract or identification number | GL 149348 | | Number of Individuals Covered | 331 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,875 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | DEPENDENT LIFE, AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $12,499 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,875 | | Insurance broker name | THE BENEFIT COMPANY, INC. |
|
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) |
| Policy contract number | A0637 |
| Policy instance | 3 |
| Insurance contract or identification number | A0637 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $24,692 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,646,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 2HLTC807 |
| Policy instance | 2 |
| Insurance contract or identification number | 2HLTC807 | | Number of Individuals Covered | 186 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $4,811 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $60,139 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-350686 |
| Policy instance | 1 |
| Insurance contract or identification number | 010-350686 | | Number of Individuals Covered | 171 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $1,577 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,514 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10046675 |
| Policy instance | 4 |
| Insurance contract or identification number | 10046675 | | Number of Individuals Covered | 338 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $835 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $5,565 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10046675 |
| Policy instance | 3 |
| Insurance contract or identification number | 10046675 | | Number of Individuals Covered | 342 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,402 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D, LIFE, DEPENDENT LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $9,349 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,402 | | Insurance broker organization code? | 3 | | Insurance broker name | GALE DAVIS & CO., INC. |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 2HLTC807 |
| Policy instance | 1 |
| Insurance contract or identification number | 2HLTC807 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $4,744 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $59,302 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,744 | | Insurance broker organization code? | 3 | | Insurance broker name | ABACUS BENEFITS MANAGEMENT, LLC |
|
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) |
| Policy contract number | A0637 |
| Policy instance | 2 |
| Insurance contract or identification number | A0637 | | Number of Individuals Covered | 280 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $25,947 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,652,448 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,947 | | Insurance broker organization code? | 3 | | Insurance broker name | BENESERV & ASSOCIATES |
|
