KING RANCH, INC. has sponsored the creation of one or more 401k plans.
Additional information about KING RANCH, INC.
Submission information for form 5500 for 401k plan GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967
401k plan membership statisitcs for GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967
| Measure | Date | Value |
|---|
| 2022: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 719 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 632 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 108 |
| Total of all active and inactive participants | 2022-01-01 | 740 |
| Total participants | 2022-01-01 | 740 |
| 2021: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 703 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 636 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 83 |
| Total of all active and inactive participants | 2021-01-01 | 719 |
| Total participants | 2021-01-01 | 719 |
| 2020: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 660 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 632 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 71 |
| Total of all active and inactive participants | 2020-01-01 | 703 |
| Total participants | 2020-01-01 | 703 |
| 2019: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 897 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 607 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 53 |
| Total of all active and inactive participants | 2019-01-01 | 660 |
| Total participants | 2019-01-01 | 660 |
| 2018: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 649 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 856 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 41 |
| Total of all active and inactive participants | 2018-01-01 | 897 |
| Total participants | 2018-01-01 | 897 |
| 2017: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 607 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 626 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 23 |
| Total of all active and inactive participants | 2017-01-01 | 649 |
| Total participants | 2017-01-01 | 649 |
| 2016: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 725 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 598 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 9 |
| Total of all active and inactive participants | 2016-01-01 | 607 |
| Total participants | 2016-01-01 | 607 |
| 2015: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 753 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 577 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 148 |
| Total of all active and inactive participants | 2015-01-01 | 725 |
| Total participants | 2015-01-01 | 725 |
| 2014: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 754 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 581 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 172 |
| Total of all active and inactive participants | 2014-01-01 | 753 |
| Total participants | 2014-01-01 | 753 |
| 2013: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 764 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 589 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 175 |
| Total of all active and inactive participants | 2013-01-01 | 764 |
| Total participants | 2013-01-01 | 764 |
| 2012: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 766 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 576 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 188 |
| Total of all active and inactive participants | 2012-01-01 | 764 |
| Total participants | 2012-01-01 | 764 |
| 2011: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 810 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 584 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 182 |
| Total of all active and inactive participants | 2011-01-01 | 766 |
| Total participants | 2011-01-01 | 766 |
| 2009: GROUP INSURANCE PLAN FOR KING RANCH, INC. 3 RIVERWAY, SUITE 1600 HOUSTON, TX 77056-1967 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 651 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 621 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 116 |
| Total of all active and inactive participants | 2009-01-01 | 737 |
| Total participants | 2009-01-01 | 737 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 000064091552 |
| Policy instance | 5 |
| Insurance contract or identification number | 000064091552 | | Insurance policy start date | 2021-07-11 | | Insurance policy end date | 2022-07-11 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1296 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $883,722 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30051461 |
| Policy instance | 2 |
| Insurance contract or identification number | 30051461 | | Number of Individuals Covered | 562 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 611 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491700 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491700 | | Number of Individuals Covered | 608 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 6091171 |
| Policy instance | 10 |
| Insurance contract or identification number | 6091171 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $6,098 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162876 |
| Policy instance | 6 |
| Insurance contract or identification number | 0162876 | | Number of Individuals Covered | 317 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $4,433 | | Total amount of fees paid to insurance company | USD $699 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $47,975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | HEALTH SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $179 | | Amount paid for insurance broker fees | 45 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162874 |
| Policy instance | 7 |
| Insurance contract or identification number | 0162874 | | Number of Individuals Covered | 245 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $8,802 | | Total amount of fees paid to insurance company | USD $1,446 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $114,303 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $367 | | Amount paid for insurance broker fees | 45 |
|
| UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 ) |
| Policy contract number | 3369 |
| Policy instance | 8 |
| Insurance contract or identification number | 3369 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $38,928 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $220,592 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,952 | | Insurance broker organization code? | 5 |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4222 |
| Policy instance | 9 |
| Insurance contract or identification number | 4222 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $23,844 | | Welfare Benefit Premiums Paid to Carrier | USD $286,392 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,075 | | Insurance broker organization code? | 5 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30051461 |
| Policy instance | 2 |
| Insurance contract or identification number | 30051461 | | Number of Individuals Covered | 593 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 573 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491700 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491700 | | Number of Individuals Covered | 620 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 000064091552 |
| Policy instance | 5 |
| Insurance contract or identification number | 000064091552 | | Number of Individuals Covered | 570 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $183 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $183 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162876 |
| Policy instance | 6 |
| Insurance contract or identification number | 0162876 | | Number of Individuals Covered | 355 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,271 | | Total amount of fees paid to insurance company | USD $1,135 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,475 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 367 | | Additional information about fees paid to insurance broker | HEALTH SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $226 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162874 |
| Policy instance | 7 |
| Insurance contract or identification number | 0162874 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $11,719 | | Total amount of fees paid to insurance company | USD $2,335 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $121,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $184 | | Amount paid for insurance broker fees | 785 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 ) |
| Policy contract number | 3369 |
| Policy instance | 8 |
| Insurance contract or identification number | 3369 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $38,213 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $216,539 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,475 | | Insurance broker organization code? | 5 |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4222 |
| Policy instance | 9 |
| Insurance contract or identification number | 4222 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $24,637 | | Welfare Benefit Premiums Paid to Carrier | USD $279,688 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,710 | | Insurance broker organization code? | 5 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1409 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,615 | | Total amount of fees paid to insurance company | USD $39,529 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $804,978 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,615 | | Amount paid for insurance broker fees | 39529 | | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1437 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of fees paid to insurance company | USD $8,988 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $720,587 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 8988 | | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30051461 |
| Policy instance | 2 |
| Insurance contract or identification number | 30051461 | | Number of Individuals Covered | 570 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 559 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491700 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491700 | | Number of Individuals Covered | 614 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 000064091552 |
| Policy instance | 5 |
| Insurance contract or identification number | 000064091552 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-07-11 | | Total amount of commissions paid to insurance broker | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162876 |
| Policy instance | 6 |
| Insurance contract or identification number | 0162876 | | Number of Individuals Covered | 389 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $5,821 | | Total amount of fees paid to insurance company | USD $945 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $59,865 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,683 | | Amount paid for insurance broker fees | 894 | | Additional information about fees paid to insurance broker | HEALTH SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162874 |
| Policy instance | 7 |
| Insurance contract or identification number | 0162874 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $13,769 | | Total amount of fees paid to insurance company | USD $1,618 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $126,636 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,473 | | Amount paid for insurance broker fees | 1567 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 ) |
| Policy contract number | 3369 |
| Policy instance | 8 |
| Insurance contract or identification number | 3369 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $38,122 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $216,024 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,415 | | Insurance broker organization code? | 5 |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4222 |
| Policy instance | 9 |
| Insurance contract or identification number | 4222 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $24,829 | | Welfare Benefit Premiums Paid to Carrier | USD $268,929 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,863 | | Insurance broker organization code? | 5 |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 000064091552 |
| Policy instance | 5 |
| Insurance contract or identification number | 000064091552 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162876 |
| Policy instance | 6 |
| Insurance contract or identification number | 0162876 | | Number of Individuals Covered | 424 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $7,314 | | Total amount of fees paid to insurance company | USD $84 | | 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 $6,794 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 84 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0147310 |
| Policy instance | 8 |
| Insurance contract or identification number | 0147310 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $84 | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 84 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 ) |
| Policy contract number | 3369 |
| Policy instance | 9 |
| Insurance contract or identification number | 3369 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $35,341 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,561 | | Insurance broker organization code? | 5 |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4222 |
| Policy instance | 10 |
| Insurance contract or identification number | 4222 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $23,888 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,110 | | Insurance broker organization code? | 5 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491700 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491700 | | Number of Individuals Covered | 708 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Dental 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 $0 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 546 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30051461 |
| Policy instance | 2 |
| Insurance contract or identification number | 30051461 | | Number of Individuals Covered | 595 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1567 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162874 |
| Policy instance | 7 |
| Insurance contract or identification number | 0162874 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $11,490 | | Total amount of fees paid to insurance company | USD $84 | | 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 $10,722 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 84 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 519 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491700 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491700 | | Number of Individuals Covered | 680 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 000064091552 |
| Policy instance | 5 |
| Insurance contract or identification number | 000064091552 | | Insurance policy start date | 2017-07-11 | | Insurance policy end date | 2018-07-11 | | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162874 |
| Policy instance | 7 |
| Insurance contract or identification number | 0162874 | | Number of Individuals Covered | 199 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $18,296 | | Total amount of fees paid to insurance company | USD $87 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $128,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,960 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 89 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30051461 |
| Policy instance | 2 |
| Insurance contract or identification number | 30051461 | | Number of Individuals Covered | 599 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1505 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0162876 |
| Policy instance | 6 |
| Insurance contract or identification number | 0162876 | | Number of Individuals Covered | 507 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $17,882 | | Total amount of fees paid to insurance company | USD $85 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $79,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,670 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 89 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1515 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of fees paid to insurance company | USD $6,420 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 6420 | | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS AND/OR BONUSES | | Insurance broker organization code? | 3 | | Insurance broker name | ALLIANT INSURANCE SERVICE |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30051461 |
| Policy instance | 2 |
| Insurance contract or identification number | 30051461 | | Number of Individuals Covered | 591 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | ALLIANT INSURANCE SERVICES |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 612 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491700 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491700 | | Number of Individuals Covered | 644 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $9,748 | | Dental 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 $9,748 | | Insurance broker organization code? | 3 | | Insurance broker name | ALLIANT INSURANCE SERVICES, INC. |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 000064091552 |
| Policy instance | 5 |
| Insurance contract or identification number | 000064091552 | | Number of Individuals Covered | 221 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | ALLIANT INSURANCE SERVICES HOUSTON |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1264 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $4,833 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $447,966 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,833 | | Insurance broker organization code? | 3 | | Insurance broker name | ALLIANT INSURANCE SERVICE |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30051461 |
| Policy instance | 2 |
| Insurance contract or identification number | 30051461 | | Number of Individuals Covered | 503 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 555 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491700 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491700 | | Number of Individuals Covered | 518 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $9,493 | | Dental 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 $9,493 | | Insurance broker name | ALLIANT INSURANCE SERVICES, INC. |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 000064091552 |
| Policy instance | 5 |
| Insurance contract or identification number | 000064091552 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $1,599 | | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,599 | | Insurance broker organization code? | 3 | | Insurance broker name | ALLIANT INSURANCE SERVICES HOUSTON |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1362 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $466,679 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | ANT INSURANCE SERVICES HOUSTON, LLC |
|
| HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 ) |
| Policy contract number | 634333 |
| Policy instance | 2 |
| Insurance contract or identification number | 634333 | | Number of Individuals Covered | 476 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 570 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491700 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491700 | | Number of Individuals Covered | 485 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 000064091552 |
| Policy instance | 5 |
| Insurance contract or identification number | 000064091552 | | Number of Individuals Covered | 508 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | ALLIANT INSURANCE SERVICES HOUSTON |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 000064091552 |
| Policy instance | 5 |
| Insurance contract or identification number | 000064091552 | | Number of Individuals Covered | 494 | | Insurance policy start date | 2012-11-07 | | Insurance policy end date | 2013-11-07 | | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | ALLIANT INSURANCE SERVICES HOUSTON |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1396 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of fees paid to insurance company | USD $5,958 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $406,985 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 5958 | | Insurance broker organization code? | 3 | | Insurance broker name | JARDINE LLOYD THOMPSON LLC |
|
| HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 ) |
| Policy contract number | 634333 |
| Policy instance | 2 |
| Insurance contract or identification number | 634333 | | Number of Individuals Covered | 499 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 574 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 ) |
| Policy contract number | 634333 |
| Policy instance | 4 |
| Insurance contract or identification number | 634333 | | Number of Individuals Covered | 480 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $171 | | Vision 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 $171 | | Insurance broker name | ALLIANT INS SER INC-HOUSTON |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00453283 |
| Policy instance | 2 |
| Insurance contract or identification number | 00453283 | | Number of Individuals Covered | 494 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $8,064 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $306,378 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,064 | | Insurance broker organization code? | 3 | | Insurance broker name | ALLIANT INSURANCE SERVICES INC |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 571 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30001439 |
| Policy instance | 4 |
| Insurance contract or identification number | 30001439 | | Number of Individuals Covered | 502 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1380 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $7,524 | | 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 $7,524 | | Insurance broker organization code? | 3 | | Insurance broker name | ALLIANT INSURANCE SERVICE, LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00453283 |
| Policy instance | 2 |
| Insurance contract or identification number | 00453283 | | Number of Individuals Covered | 491 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $6,596 | | Total amount of fees paid to insurance company | USD $8,012 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $306,378 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1328 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of fees paid to insurance company | USD $7,944 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30001439 |
| Policy instance | 4 |
| Insurance contract or identification number | 30001439 | | Number of Individuals Covered | 510 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Vision Insurance Welfare Benefit | Yes |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 587 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 604279 |
| Policy instance | 3 |
| Insurance contract or identification number | 604279 | | Number of Individuals Covered | 636 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00453283 |
| Policy instance | 2 |
| Insurance contract or identification number | 00453283 | | Number of Individuals Covered | 552 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $6,517 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $301,180 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 88366 |
| Policy instance | 1 |
| Insurance contract or identification number | 88366 | | Number of Individuals Covered | 1285 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $269,501 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30001439 |
| Policy instance | 4 |
| Insurance contract or identification number | 30001439 | | Number of Individuals Covered | 499 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
