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SECTION 125 CAFETERIA PLAN 401k Plan overview

Plan NameSECTION 125 CAFETERIA PLAN
Plan identification number 501

SECTION 125 CAFETERIA PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

ACE DISPOSAL has sponsored the creation of one or more 401k plans.

Company Name:ACE DISPOSAL
Employer identification number (EIN):870481948
NAIC Classification:562000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SECTION 125 CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-06-01
5012022-01-01
5012021-06-01
5012021-01-01
5012020-06-01
5012020-01-01
5012019-06-01
5012019-01-01
5012018-06-01
5012018-01-01STEPHEN RICHARDS STEPHEN RICHARDS2019-07-05
5012017-06-01
5012017-01-01STEPHEN RICHARDS STEPHEN RICHARDS2018-07-16
5012016-06-01STEPHEN RICHARDS
5012016-01-01STEPHEN RICHARDS STEPHEN RICHARDS2017-07-24
5012015-06-01STEPHEN RICHARDS
5012015-01-01STEPHEN RICHARDS STEPHEN RICHARDS2016-07-28
5012014-06-01STEPHEN RICHARDS
5012014-01-01STEPHEN RICHARDS STEPHEN RICHARDS2015-07-30
5012013-01-01STEPHEN RICHARDS STEPHEN RICHARDS2014-07-25
5012012-01-01STEPHEN RICHARDS STEPHEN RICHARDS2013-07-29
5012011-01-01STEPHEN RICHARDS STEPHEN RICHARDS2012-07-19

Plan Statistics for SECTION 125 CAFETERIA PLAN

401k plan membership statisitcs for SECTION 125 CAFETERIA PLAN

Measure Date Value
2022: SECTION 125 CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01257
Total number of active participants reported on line 7a of the Form 55002022-06-01274
Total of all active and inactive participants2022-06-01274
Total participants2022-06-01274
Total participants, beginning-of-year2022-01-01154
Total number of active participants reported on line 7a of the Form 55002022-01-01128
Total of all active and inactive participants2022-01-01128
Total participants2022-01-01128
2021: SECTION 125 CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01259
Total number of active participants reported on line 7a of the Form 55002021-06-01257
Total of all active and inactive participants2021-06-01257
Total participants2021-06-01257
Total participants, beginning-of-year2021-01-01153
Total number of active participants reported on line 7a of the Form 55002021-01-01134
Total of all active and inactive participants2021-01-01134
Total participants2021-01-01134
2020: SECTION 125 CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01253
Total number of active participants reported on line 7a of the Form 55002020-06-01253
Total of all active and inactive participants2020-06-01253
Total participants2020-06-01253
Total participants, beginning-of-year2020-01-01164
Total number of active participants reported on line 7a of the Form 55002020-01-01144
Total of all active and inactive participants2020-01-01144
Total participants2020-01-01144
2019: SECTION 125 CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01238
Total number of active participants reported on line 7a of the Form 55002019-06-01250
Total of all active and inactive participants2019-06-01250
Total participants2019-06-01250
Number of participants with account balances2019-06-010
Total participants, beginning-of-year2019-01-01167
Total number of active participants reported on line 7a of the Form 55002019-01-01146
Total of all active and inactive participants2019-01-01146
Total participants2019-01-01146
2018: SECTION 125 CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01225
Total number of active participants reported on line 7a of the Form 55002018-06-01238
Total of all active and inactive participants2018-06-01238
Total participants2018-06-01238
Total participants, beginning-of-year2018-01-01145
Total number of active participants reported on line 7a of the Form 55002018-01-01133
Total of all active and inactive participants2018-01-01133
Total participants2018-01-01133
2017: SECTION 125 CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01192
Total number of active participants reported on line 7a of the Form 55002017-06-01215
Number of retired or separated participants receiving benefits2017-06-010
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-01215
Total participants, beginning-of-year2017-01-01133
Total number of active participants reported on line 7a of the Form 55002017-01-01122
Total of all active and inactive participants2017-01-01122
Total participants2017-01-01122
2016: SECTION 125 CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01181
Total number of active participants reported on line 7a of the Form 55002016-06-01195
Number of retired or separated participants receiving benefits2016-06-010
Number of other retired or separated participants entitled to future benefits2016-06-010
Total of all active and inactive participants2016-06-01195
Total participants, beginning-of-year2016-01-01103
Total number of active participants reported on line 7a of the Form 55002016-01-0195
Total of all active and inactive participants2016-01-0195
Total participants2016-01-0195
2015: SECTION 125 CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01159
Total number of active participants reported on line 7a of the Form 55002015-06-01181
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-01181
Total participants, beginning-of-year2015-01-01105
Total number of active participants reported on line 7a of the Form 55002015-01-0194
Total of all active and inactive participants2015-01-0194
Total participants2015-01-0194
2014: SECTION 125 CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01135
Total number of active participants reported on line 7a of the Form 55002014-06-01159
Number of retired or separated participants receiving benefits2014-06-010
Number of other retired or separated participants entitled to future benefits2014-06-010
Total of all active and inactive participants2014-06-01159
Total participants, beginning-of-year2014-01-01105
Total number of active participants reported on line 7a of the Form 55002014-01-0197
Total of all active and inactive participants2014-01-0197
Total participants2014-01-0197
2013: SECTION 125 CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01103
Total number of active participants reported on line 7a of the Form 55002013-01-0195
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0195
Number of participants with account balances2013-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: SECTION 125 CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01103
Total number of active participants reported on line 7a of the Form 55002012-01-0197
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0197
Number of participants with account balances2012-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: SECTION 125 CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01109
Total number of active participants reported on line 7a of the Form 55002011-01-01100
Total of all active and inactive participants2011-01-01100
Total participants2011-01-01100

Form 5500 Responses for SECTION 125 CAFETERIA PLAN

2022: SECTION 125 CAFETERIA PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: SECTION 125 CAFETERIA PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: SECTION 125 CAFETERIA PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: SECTION 125 CAFETERIA PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: SECTION 125 CAFETERIA PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: SECTION 125 CAFETERIA PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: SECTION 125 CAFETERIA PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: SECTION 125 CAFETERIA PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: SECTION 125 CAFETERIA PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: SECTION 125 CAFETERIA PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: SECTION 125 CAFETERIA PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: SECTION 125 CAFETERIA PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )
Policy contract numberG10277731001
Policy instance 5
Insurance contract or identification numberG10277731001
Number of Individuals Covered706
Insurance policy start date2023-01-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $6,830
Welfare Benefit Premiums Paid to CarrierUSD $41,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,830
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL37227
Policy instance 4
Insurance contract or identification numberHCL37227
Number of Individuals Covered276
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $62,103
Welfare Benefit Premiums Paid to CarrierUSD $677,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $62,103
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number0102028700
Policy instance 3
Insurance contract or identification number0102028700
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $44,021
Total amount of fees paid to insurance companyUSD $31,281
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $313,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,021
Insurance broker organization code?3
Amount paid for insurance broker fees31281
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract number
Policy instance 2
Number of Individuals Covered1577
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $2,547
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,547
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberUTX58150
Policy instance 1
Insurance contract or identification numberUTX58150
Number of Individuals Covered711
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $12,710
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $180,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,710
Insurance broker organization code?3
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract number
Policy instance 2
Number of Individuals Covered181
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $2,350
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,350
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number0102028700
Policy instance 3
Insurance contract or identification number0102028700
Number of Individuals Covered324
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $33,404
Total amount of fees paid to insurance companyUSD $3,353
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $237,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,404
Insurance broker organization code?3
Amount paid for insurance broker fees3353
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number
Policy instance 4
Number of Individuals Covered251
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $61,173
Welfare Benefit Premiums Paid to CarrierUSD $611,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,173
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberUTX58150
Policy instance 1
Insurance contract or identification numberUTX58150
Number of Individuals Covered608
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $13,825
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $198,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,825
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number
Policy instance 4
Number of Individuals Covered255
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of fees paid to insurance companyUSD $54,969
Welfare Benefit Premiums Paid to CarrierUSD $549,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees54969
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00615786
Policy instance 3
Insurance contract or identification numberG 00615786
Number of Individuals Covered327
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $19,780
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $160,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,780
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract number
Policy instance 2
Number of Individuals Covered179
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $2,201
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,201
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberUTX58150
Policy instance 1
Insurance contract or identification numberUTX58150
Number of Individuals Covered610
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $13,552
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $194,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,552
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00305UT-06
Policy instance 2
Insurance contract or identification numberGB00305UT-06
Number of Individuals Covered250
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $14,400
Welfare Benefit Premiums Paid to CarrierUSD $530,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,400
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00615786
Policy instance 5
Insurance contract or identification numberG 00615786
Number of Individuals Covered307
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $19,605
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $146,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,605
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract number
Policy instance 4
Number of Individuals Covered163
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $2,214
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,137
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,214
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberUTX58150
Policy instance 3
Insurance contract or identification numberUTX58150
Number of Individuals Covered566
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $12,527
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $179,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,527
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00305UT-07
Policy instance 1
Insurance contract or identification numberGB00305UT-07
Number of Individuals Covered240
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $53,136
Welfare Benefit Premiums Paid to CarrierUSD $531,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $53,136
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00305UT-06
Policy instance 1
Insurance contract or identification numberGB00305UT-06
Number of Individuals Covered237
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $13,845
Welfare Benefit Premiums Paid to CarrierUSD $508,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,845
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00615786
Policy instance 5
Insurance contract or identification numberG 00615786
Number of Individuals Covered294
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $17,097
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $128,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,097
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract number
Policy instance 4
Number of Individuals Covered155
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $2,006
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,006
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00305UT-06
Policy instance 2
Insurance contract or identification numberGB00305UT-06
Number of Individuals Covered202
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $50,804
Welfare Benefit Premiums Paid to CarrierUSD $508,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,804
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberUTX58150
Policy instance 3
Insurance contract or identification numberUTX58150
Number of Individuals Covered536
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $11,409
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $167,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,409
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG00615786
Policy instance 4
Insurance contract or identification numberG00615786
Number of Individuals Covered254
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $15,324
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEPENDENT VOLUNTARY TERM AD&D
Welfare Benefit Premiums Paid to CarrierUSD $115,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract number
Policy instance 3
Number of Individuals Covered129
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $1,679
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberUTX58150
Policy instance 2
Insurance contract or identification numberUTX58150
Number of Individuals Covered469
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $10,544
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $150,483
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00305UT-05
Policy instance 1
Insurance contract or identification numberGB00305UT-05
Number of Individuals Covered205
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $62,074
Welfare Benefit Premiums Paid to CarrierUSD $413,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AA8I
Policy instance 4
Insurance contract or identification numberGLTD0AA8I
Number of Individuals Covered191
Insurance policy start date2014-03-01
Insurance policy end date2015-03-01
Total amount of commissions paid to insurance brokerUSD $3,401
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,401
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameWELLER INVESTMENT & INSURANCE
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AA8I
Policy instance 3
Insurance contract or identification numberGVTL0AA8I
Number of Individuals Covered89
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $2,489
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,489
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameWELLER INVESTMENT & INSURANCE
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AA8I
Policy instance 2
Insurance contract or identification numberGLUG0AA8I
Number of Individuals Covered189
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $520
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $520
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameWELLER INVESTMENT & INSURANCE
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00305UT-02
Policy instance 1
Insurance contract or identification numberGB00305UT-02
Number of Individuals Covered166
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $47,917
Welfare Benefit Premiums Paid to CarrierUSD $319,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,917
Insurance broker nameWANSUTTER INSURANCE & RISK MGMT.

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