MOUNTAIN WEST ANESTHESIA, L.L.C. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MOUNTAIN WEST ANESTHESIA MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2022: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 177 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 178 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 4 |
| Total of all active and inactive participants | 2022-01-01 | 182 |
| 2021: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 175 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 2 |
| Total of all active and inactive participants | 2021-01-01 | 177 |
| 2020: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 162 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 153 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 155 |
| 2019: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 159 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 162 |
| 2018: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 153 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 155 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 8 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 163 |
| 2017: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 151 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 153 |
| 2014: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 137 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 3 |
| Total of all active and inactive participants | 2014-01-01 | 140 |
| 2013: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 135 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 3 |
| Total of all active and inactive participants | 2013-01-01 | 138 |
| 2012: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 136 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 2 |
| Total of all active and inactive participants | 2012-01-01 | 138 |
| Total participants | 2012-01-01 | 0 |
| 2011: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 143 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 150 |
| Total of all active and inactive participants | 2011-01-01 | 150 |
| Total participants | 2011-01-01 | 150 |
| 2010: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 140 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 143 |
| Total of all active and inactive participants | 2010-01-01 | 143 |
| Total participants | 2010-01-01 | 143 |
| 2009: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 139 |
| Total of all active and inactive participants | 2009-01-01 | 139 |
| Total participants | 2009-01-01 | 139 |
| 2008: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-01-01 | 123 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-01-01 | 135 |
| Number of retired or separated participants receiving benefits | 2008-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-01-01 | 0 |
| Total of all active and inactive participants | 2008-01-01 | 135 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2008-01-01 | 0 |
| Total participants | 2008-01-01 | 135 |
| Number of participants with account balances | 2008-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2008-01-01 | 0 |
| 2007: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-01-01 | 126 |
| Number of retired or separated participants receiving benefits | 2007-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-01-01 | 0 |
| Total of all active and inactive participants | 2007-01-01 | 126 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2007-01-01 | 0 |
| Total participants | 2007-01-01 | 126 |
| Number of participants with account balances | 2007-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2007-01-01 | 0 |
| 2006: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-01-01 | 113 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-01-01 | 121 |
| Total of all active and inactive participants | 2006-01-01 | 121 |
| Total participants | 2006-01-01 | 121 |
| 2022: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | First time form 5500 has been submitted | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | Yes |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2008 form 5500 responses |
|---|
| 2008-01-01 | Type of plan entity | Single employer plan |
| 2008-01-01 | Submission has been amended | No |
| 2008-01-01 | This submission is the final filing | No |
| 2008-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-01-01 | Plan is a collectively bargained plan | No |
| 2008-01-01 | Plan funding arrangement – Insurance | Yes |
| 2008-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2007 form 5500 responses |
|---|
| 2007-01-01 | Type of plan entity | Single employer plan |
| 2007-01-01 | Submission has been amended | No |
| 2007-01-01 | This submission is the final filing | No |
| 2007-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-01-01 | Plan is a collectively bargained plan | No |
| 2007-01-01 | Plan funding arrangement – Insurance | Yes |
| 2007-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: MOUNTAIN WEST ANESTHESIA MEDICAL PLAN 2006 form 5500 responses |
|---|
| 2006-01-01 | Type of plan entity | Single employer plan |
| 2006-01-01 | Submission has been amended | No |
| 2006-01-01 | This submission is the final filing | No |
| 2006-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-01-01 | Plan is a collectively bargained plan | No |
| 2006-01-01 | Plan funding arrangement – Insurance | Yes |
| 2006-01-01 | Plan benefit arrangement – Insurance | Yes |
| DENTIST DIRECT, LLC (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | RCX011 |
| Policy instance | 3 |
| Insurance contract or identification number | RCX011 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $479 | | 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 | | Commission paid to Insurance Broker | USD $479 | | Insurance broker organization code? | 0 |
|
| DENTIST DIRECT, LLC (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | RCX011 |
| Policy instance | 2 |
| Insurance contract or identification number | RCX011 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $6,653 | | Total amount of fees paid to insurance company | 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 $6,653 | | Insurance broker organization code? | 0 |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1019155 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1019155 1001 | | Number of Individuals Covered | 780 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $103,730 | | Total amount of fees paid to insurance company | USD $34,576 | | 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 $103,730 | | Amount paid for insurance broker fees | 34576 | | Insurance broker organization code? | 3 |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1019155 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1019155 1001 | | Number of Individuals Covered | 818 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $103,930 | | Total amount of fees paid to insurance company | USD $33,931 | | Health Insurance Welfare Benefit | Yes | | 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 $103,930 | | Amount paid for insurance broker fees | 33931 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1019155 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1019155 1001 | | Number of Individuals Covered | 710 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $102,397 | | Total amount of fees paid to insurance company | USD $33,707 | | Health Insurance Welfare Benefit | Yes | | 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 $102,397 | | Amount paid for insurance broker fees | 33707 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1019155 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1019155 1001 | | Number of Individuals Covered | 722 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $94,477 | | Total amount of fees paid to insurance company | USD $31,193 | | Health Insurance Welfare Benefit | Yes | | 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 $94,477 | | Amount paid for insurance broker fees | 31193 | | Insurance broker organization code? | 3 |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1019155 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1019155 1001 | | Number of Individuals Covered | 1636 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $87,980 | | Total amount of fees paid to insurance company | USD $28,548 | | Health Insurance Welfare Benefit | Yes | | 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 $87,980 | | Amount paid for insurance broker fees | 28548 | | Insurance broker organization code? | 3 |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1019155 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1019155 1001 | | Number of Individuals Covered | 687 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $49,153 | | Total amount of fees paid to insurance company | USD $16,199 | | 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 $49,153 | | Amount paid for insurance broker fees | 16199 | | Additional information about fees paid to insurance broker | OTHER FEES PAID | | Insurance broker organization code? | 3 | | Insurance broker name | GBS BENEFITS |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006975 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1006975 1001 | | Number of Individuals Covered | 549 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $40,987 | | Total amount of fees paid to insurance company | USD $13,936 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $40,987 | | Amount paid for insurance broker fees | 13936 | | Additional information about fees paid to insurance broker | OTHER FEES PAID | | Insurance broker organization code? | 3 | | Insurance broker name | NIELSEN INSURANCE GROUP, INC. |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006975 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1006975 1001 | | Number of Individuals Covered | 545 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $39,303 | | Total amount of fees paid to insurance company | USD $9,109 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $39,303 | | Amount paid for insurance broker fees | 9109 | | Insurance broker name | NELSEN INSURANCE GROUP, INC. |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006975 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1006975 1001 | | Number of Individuals Covered | 562 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $38,467 | | Total amount of fees paid to insurance company | USD $13,079 | | 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 $38,467 | | Amount paid for insurance broker fees | 13079 | | Insurance broker name | NIELSEN INSURANCE GROUP, INC. |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006975 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1006975 1001 | | Number of Individuals Covered | 582 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $37,739 | | Total amount of fees paid to insurance company | USD $12,831 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006975 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1006975 1001 | | Number of Individuals Covered | 556 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $36,988 | | Total amount of fees paid to insurance company | USD $12,576 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006975 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1006975 1001 | | Number of Individuals Covered | 542 | | Insurance policy start date | 2009-01-01 | | Insurance policy end date | 2009-12-31 | | Total amount of commissions paid to insurance broker | USD $39,695 | | Total amount of fees paid to insurance company | USD $13,898 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006975 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1006975 1001 | | Number of Individuals Covered | 528 | | Insurance policy start date | 2008-01-01 | | Insurance policy end date | 2008-12-31 | | Total amount of commissions paid to insurance broker | USD $37,210 | | Total amount of fees paid to insurance company | USD $12,943 | | 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 $37,210 | | Amount paid for insurance broker fees | 12943 | | Insurance broker name | NIELSEN INSURANCE GROUP, INC |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006975 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1006975 1001 | | Number of Individuals Covered | 533 | | Insurance policy start date | 2007-01-01 | | Insurance policy end date | 2007-12-31 | | Total amount of commissions paid to insurance broker | USD $33,024 | | Total amount of fees paid to insurance company | USD $1,967 | | 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 $33,024 | | Amount paid for insurance broker fees | 1967 | | Insurance broker name | NIELSEN INSURANCE GROUP, INC |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006975 1001 |
| Policy instance | 1 |
| Insurance contract or identification number | G1006975 1001 | | Number of Individuals Covered | 531 | | Insurance policy start date | 2006-01-01 | | Insurance policy end date | 2006-12-31 | | Total amount of commissions paid to insurance broker | USD $6,687 | | 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 $6,687 | | Insurance broker name | NIELSEN INSURANCE GROUP, INC |
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