KENTUCKY PRIMARY CARE ASSOCIATION HEALTH AND BENEFITS TRUST has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan KENTUCKY PRIMARY CARE ASSOCIATION HEALTH & BENEFITS TRUST
401k plan membership statisitcs for KENTUCKY PRIMARY CARE ASSOCIATION HEALTH & BENEFITS TRUST
| Measure | Date | Value |
|---|
| 2022 : KENTUCKY PRIMARY CARE ASSOCIATION HEALTH & BENEFITS TRUST 2022 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $73,707 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $601,001 |
| Total income from all sources (including contributions) | 2022-12-31 | $7,260,693 |
| Total of all expenses incurred | 2022-12-31 | $7,244,771 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $7,100,558 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $7,255,824 |
| Value of total assets at end of year | 2022-12-31 | $335,904 |
| Value of total assets at beginning of year | 2022-12-31 | $847,276 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $144,213 |
| Total interest from all sources | 2022-12-31 | $4,869 |
| Administrative expenses professional fees incurred | 2022-12-31 | $10,986 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $962 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $8 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $183,922 |
| Administrative expenses (other) incurred | 2022-12-31 | $8,387 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $16,810 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $14,608 |
| Value of net income/loss | 2022-12-31 | $15,922 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $262,197 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $246,275 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $272,826 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $418,084 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $418,084 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $4,869 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $7,100,558 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $7,255,824 |
| Employer contributions (assets) at end of year | 2022-12-31 | $62,116 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $429,184 |
| Contract administrator fees | 2022-12-31 | $124,840 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $56,897 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $402,471 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | FRANK N HESTAND CPA PSC |
| Accountancy firm EIN | 2022-12-31 | 611336870 |
| 2021 : KENTUCKY PRIMARY CARE ASSOCIATION HEALTH & BENEFITS TRUST 2021 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $601,001 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $166,222 |
| Total income from all sources (including contributions) | 2021-12-31 | $6,358,809 |
| Total of all expenses incurred | 2021-12-31 | $6,143,996 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $6,045,366 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $6,358,768 |
| Value of total assets at end of year | 2021-12-31 | $847,276 |
| Value of total assets at beginning of year | 2021-12-31 | $197,684 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $98,630 |
| Total interest from all sources | 2021-12-31 | $41 |
| Administrative expenses professional fees incurred | 2021-12-31 | $4,000 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $8 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $1 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $183,922 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $97,980 |
| Administrative expenses (other) incurred | 2021-12-31 | $3,609 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $14,608 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $12,012 |
| Value of net income/loss | 2021-12-31 | $214,813 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $246,275 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $31,462 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $418,084 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $96,937 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $96,937 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $41 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $6,045,366 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $6,358,768 |
| Employer contributions (assets) at end of year | 2021-12-31 | $429,184 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $100,746 |
| Contract administrator fees | 2021-12-31 | $91,021 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $402,471 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $56,230 |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | FRANK N HESTAND CPA PSC |
| Accountancy firm EIN | 2021-12-31 | 611336870 |
| 2020 : KENTUCKY PRIMARY CARE ASSOCIATION HEALTH & BENEFITS TRUST 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $166,222 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $184,042 |
| Total income from all sources (including contributions) | 2020-12-31 | $5,583,419 |
| Total of all expenses incurred | 2020-12-31 | $5,564,168 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $5,463,274 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $5,583,131 |
| Value of total assets at end of year | 2020-12-31 | $197,684 |
| Value of total assets at beginning of year | 2020-12-31 | $196,253 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $100,894 |
| Total interest from all sources | 2020-12-31 | $288 |
| Administrative expenses professional fees incurred | 2020-12-31 | $4,000 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $1 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $85 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $97,980 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $52,686 |
| Administrative expenses (other) incurred | 2020-12-31 | $3,632 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $12,012 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $9,138 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $95 |
| Value of net income/loss | 2020-12-31 | $19,251 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $31,462 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $12,211 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $96,937 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $66,999 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $66,999 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $288 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $5,463,274 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $5,583,131 |
| Employer contributions (assets) at end of year | 2020-12-31 | $100,746 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $129,074 |
| Contract administrator fees | 2020-12-31 | $93,262 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $56,230 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $122,218 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | FRANK N HESTAND CPA PSC |
| Accountancy firm EIN | 2020-12-31 | 611336870 |
| 2019 : KENTUCKY PRIMARY CARE ASSOCIATION HEALTH & BENEFITS TRUST 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $184,042 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $37,741 |
| Total income from all sources (including contributions) | 2019-12-31 | $4,075,939 |
| Total of all expenses incurred | 2019-12-31 | $4,064,080 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $3,989,413 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $4,074,964 |
| Value of total assets at end of year | 2019-12-31 | $196,253 |
| Value of total assets at beginning of year | 2019-12-31 | $38,093 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $74,667 |
| Total interest from all sources | 2019-12-31 | $975 |
| Administrative expenses professional fees incurred | 2019-12-31 | $4,000 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $85 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $17,733 |
| Administrative expenses (other) incurred | 2019-12-31 | $3,676 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $61,824 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $37,251 |
| Total non interest bearing cash at end of year | 2019-12-31 | $95 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $95 |
| Value of net income/loss | 2019-12-31 | $11,859 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $12,211 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $352 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $66,999 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $14,157 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $14,157 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $975 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $3,989,413 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $4,074,964 |
| Employer contributions (assets) at end of year | 2019-12-31 | $129,074 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $6,108 |
| Contract administrator fees | 2019-12-31 | $66,991 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $122,218 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $490 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Accountancy firm name | 2019-12-31 | FRANK N HESTAND CPA PSC |
| Accountancy firm EIN | 2019-12-31 | 611336870 |
| 2018 : KENTUCKY PRIMARY CARE ASSOCIATION HEALTH & BENEFITS TRUST 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $37,741 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $2,088 |
| Total income from all sources (including contributions) | 2018-12-31 | $3,016,131 |
| Total of all expenses incurred | 2018-12-31 | $3,015,809 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $2,967,363 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $3,015,621 |
| Value of total assets at end of year | 2018-12-31 | $38,093 |
| Value of total assets at beginning of year | 2018-12-31 | $2,118 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $48,446 |
| Total interest from all sources | 2018-12-31 | $510 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $17,733 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $5 |
| Administrative expenses (other) incurred | 2018-12-31 | $198 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $37,251 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $1,829 |
| Total non interest bearing cash at end of year | 2018-12-31 | $95 |
| Value of net income/loss | 2018-12-31 | $322 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $352 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $30 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $14,157 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $1,882 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $1,882 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $510 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $2,967,363 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $3,015,621 |
| Employer contributions (assets) at end of year | 2018-12-31 | $6,108 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $231 |
| Contract administrator fees | 2018-12-31 | $48,248 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $490 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $259 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | FRANK N HESTAND CPA PSC |
| Accountancy firm EIN | 2018-12-31 | 611336870 |
| 2017 : KENTUCKY PRIMARY CARE ASSOCIATION HEALTH & BENEFITS TRUST 2017 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $2,088 |
| Total income from all sources (including contributions) | 2017-12-31 | $1,355,120 |
| Total of all expenses incurred | 2017-12-31 | $1,355,090 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $1,333,716 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $1,354,956 |
| Value of total assets at end of year | 2017-12-31 | $2,118 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $21,374 |
| Total interest from all sources | 2017-12-31 | $164 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $5 |
| Administrative expenses (other) incurred | 2017-12-31 | $134 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $1,829 |
| Value of net income/loss | 2017-12-31 | $30 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $30 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $1,882 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $164 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $1,333,716 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $1,354,956 |
| Employer contributions (assets) at end of year | 2017-12-31 | $231 |
| Contract administrator fees | 2017-12-31 | $21,240 |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $259 |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | FRANK N HESTAND CPA PSC |
| Accountancy firm EIN | 2017-12-31 | 611336870 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 166143 |
| Policy instance | 5 |
| Insurance contract or identification number | 166143 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,266 | | Total amount of fees paid to insurance company | USD $712 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,943 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,266 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 712 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 166143 |
| Policy instance | 4 |
| Insurance contract or identification number | 166143 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,589 | | Total amount of fees paid to insurance company | USD $852 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,501 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,589 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 852 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 162945 |
| Policy instance | 3 |
| Insurance contract or identification number | 162945 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $8,717 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability 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 $4,060 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 ) |
| Policy contract number | 706560 |
| Policy instance | 2 |
| Insurance contract or identification number | 706560 | | Number of Individuals Covered | 290 | | 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 |
|
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 770 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $182,465 | | Total amount of fees paid to insurance company | USD $416 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,866,397 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $108,026 | | Amount paid for insurance broker fees | 416 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 162945 |
| Policy instance | 4 |
| Insurance contract or identification number | 162945 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $8,719 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability 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 $4,061 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 162945 |
| Policy instance | 5 |
| Insurance contract or identification number | 162945 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $7,656 | | Total amount of fees paid to insurance company | USD $3,804 | | Temporary Disability 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 | 3804 | | Insurance broker organization code? | 4 | | Commission paid to Insurance Broker | USD $3,458 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 166143 |
| Policy instance | 6 |
| Insurance contract or identification number | 166143 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,380 | | Total amount of fees paid to insurance company | USD $422 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,670 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,380 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 422 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 166143 |
| Policy instance | 7 |
| Insurance contract or identification number | 166143 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,640 | | Total amount of fees paid to insurance company | USD $505 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,176 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,640 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 505 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 166143 |
| Policy instance | 3 |
| Insurance contract or identification number | 166143 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $10,554 | | Total amount of fees paid to insurance company | USD $3,619 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability 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 $4,935 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3619 | | Additional information about fees paid to insurance broker | ADMNISTRATION FEES |
|
| DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 ) |
| Policy contract number | 706560 |
| Policy instance | 2 |
| Insurance contract or identification number | 706560 | | Number of Individuals Covered | 306 | | 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 |
|
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 542 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,378,789 | | 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 | 162945 |
| Policy instance | 4 |
| Insurance contract or identification number | 162945 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $24,515 | | Total amount of fees paid to insurance company | USD $6,608 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability 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 $11,238 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6608 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 166143 |
| Policy instance | 3 |
| Insurance contract or identification number | 166143 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $3,154 | | Total amount of fees paid to insurance company | USD $947 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,154 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 947 |
|
| DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 ) |
| Policy contract number | 706560 |
| Policy instance | 2 |
| Insurance contract or identification number | 706560 | | Number of Individuals Covered | 292 | | 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 |
|
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 376 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,168,561 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 376 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,737,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 ) |
| Policy contract number | 706560 |
| Policy instance | 2 |
| Insurance contract or identification number | 706560 | | Number of Individuals Covered | 220 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 376 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $62,479 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,680,696 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,831 |
|
| DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 ) |
| Policy contract number | 706560 |
| Policy instance | 2 |
| Insurance contract or identification number | 706560 | | Number of Individuals Covered | 92 | | 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 |
|
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 225 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,333,457 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
