THE TJX COMPANIES, INC. has sponsored the creation of one or more 401k plans.
Additional information about THE TJX COMPANIES, INC.
Measure | Date | Value |
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2015 : ZEBA 2015 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $30,331,651 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $35,024,810 |
Total income from all sources (including contributions) | 2015-12-31 | $351,311,222 |
Total of all expenses incurred | 2015-12-31 | $381,068,187 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $364,933,711 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $351,311,057 |
Value of total assets at end of year | 2015-12-31 | $574,686 |
Value of total assets at beginning of year | 2015-12-31 | $35,024,810 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $16,134,476 |
Total interest from all sources | 2015-12-31 | $165 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
Value of fidelity bond cover | 2015-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
Contributions received from participants | 2015-12-31 | $115,683,961 |
Participant contributions at end of year | 2015-12-31 | $0 |
Participant contributions at beginning of year | 2015-12-31 | $59,805 |
Assets. Other investments not covered elsewhere at end of year | 2015-12-31 | $479,432 |
Assets. Other investments not covered elsewhere at beginning of year | 2015-12-31 | $5,000 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $95,254 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $336,212 |
Administrative expenses (other) incurred | 2015-12-31 | $3,333,078 |
Total non interest bearing cash at end of year | 2015-12-31 | $0 |
Total non interest bearing cash at beginning of year | 2015-12-31 | $107,398 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Value of net income/loss | 2015-12-31 | $-29,756,965 |
Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $-29,756,965 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $0 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $12,000,000 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $12,000,000 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $165 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $66,064,887 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
Contributions received in cash from employer | 2015-12-31 | $235,627,096 |
Employer contributions (assets) at end of year | 2015-12-31 | $0 |
Employer contributions (assets) at beginning of year | 2015-12-31 | $22,516,395 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $298,868,824 |
Contract administrator fees | 2015-12-31 | $12,801,398 |
Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $30,331,651 |
Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $35,024,810 |
Did the plan have assets held for investment | 2015-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
Accountancy firm name | 2015-12-31 | PRICEWATERHOUSE COOPERS, LLP |
Accountancy firm EIN | 2015-12-31 | 134008324 |
2014 : ZEBA 2014 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $35,024,810 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $33,913,493 |
Total income from all sources (including contributions) | 2014-12-31 | $358,847,139 |
Total of all expenses incurred | 2014-12-31 | $358,847,139 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $343,052,105 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $358,846,899 |
Value of total assets at end of year | 2014-12-31 | $35,024,810 |
Value of total assets at beginning of year | 2014-12-31 | $33,913,493 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $15,795,034 |
Total interest from all sources | 2014-12-31 | $240 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
Value of fidelity bond cover | 2014-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
Contributions received from participants | 2014-12-31 | $108,542,556 |
Participant contributions at end of year | 2014-12-31 | $59,805 |
Participant contributions at beginning of year | 2014-12-31 | $2,044,856 |
Assets. Other investments not covered elsewhere at end of year | 2014-12-31 | $5,000 |
Assets. Other investments not covered elsewhere at beginning of year | 2014-12-31 | $5,000 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $336,212 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $783,433 |
Administrative expenses (other) incurred | 2014-12-31 | $4,161,041 |
Total non interest bearing cash at end of year | 2014-12-31 | $107,398 |
Total non interest bearing cash at beginning of year | 2014-12-31 | $230,782 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $12,000,000 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $15,000,000 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $15,000,000 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $240 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $62,776,760 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
Contributions received in cash from employer | 2014-12-31 | $250,304,343 |
Employer contributions (assets) at end of year | 2014-12-31 | $22,516,395 |
Employer contributions (assets) at beginning of year | 2014-12-31 | $15,849,422 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $280,275,345 |
Contract administrator fees | 2014-12-31 | $11,633,993 |
Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $35,024,810 |
Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $33,913,493 |
Did the plan have assets held for investment | 2014-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
Accountancy firm name | 2014-12-31 | PRICEWATERHOUSE COOPERS, LLP |
Accountancy firm EIN | 2014-12-31 | 134008324 |
2013 : ZEBA 2013 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $33,913,493 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $22,262,095 |
Total income from all sources (including contributions) | 2013-12-31 | $330,028,465 |
Total of all expenses incurred | 2013-12-31 | $330,553,271 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $318,648,512 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $330,028,134 |
Value of total assets at end of year | 2013-12-31 | $33,913,493 |
Value of total assets at beginning of year | 2013-12-31 | $22,786,901 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $11,904,759 |
Total interest from all sources | 2013-12-31 | $331 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
Value of fidelity bond cover | 2013-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
Contributions received from participants | 2013-12-31 | $104,418,968 |
Participant contributions at end of year | 2013-12-31 | $2,044,856 |
Participant contributions at beginning of year | 2013-12-31 | $3,892,633 |
Assets. Other investments not covered elsewhere at end of year | 2013-12-31 | $5,000 |
Assets. Other investments not covered elsewhere at beginning of year | 2013-12-31 | $5,000 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $783,433 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $845,743 |
Administrative expenses (other) incurred | 2013-12-31 | $939,795 |
Total non interest bearing cash at end of year | 2013-12-31 | $230,782 |
Total non interest bearing cash at beginning of year | 2013-12-31 | $293,525 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Value of net income/loss | 2013-12-31 | $-524,806 |
Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $524,806 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $15,000,000 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $13,000,000 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $13,000,000 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $331 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $60,039,296 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
Contributions received in cash from employer | 2013-12-31 | $225,609,166 |
Employer contributions (assets) at end of year | 2013-12-31 | $15,849,422 |
Employer contributions (assets) at beginning of year | 2013-12-31 | $4,750,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $258,609,216 |
Contract administrator fees | 2013-12-31 | $10,964,964 |
Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $33,913,493 |
Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $22,262,095 |
Did the plan have assets held for investment | 2013-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
Accountancy firm name | 2013-12-31 | PRICEWATERHOUSE COOPERS, LLP |
Accountancy firm EIN | 2013-12-31 | 134008324 |
2012 : ZEBA 2012 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $22,262,095 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $19,636,198 |
Total income from all sources (including contributions) | 2012-12-31 | $310,585,182 |
Total of all expenses incurred | 2012-12-31 | $310,024,561 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $298,248,543 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $310,585,048 |
Value of total assets at end of year | 2012-12-31 | $22,786,901 |
Value of total assets at beginning of year | 2012-12-31 | $19,600,383 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $11,776,018 |
Total interest from all sources | 2012-12-31 | $134 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
Value of fidelity bond cover | 2012-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
Contributions received from participants | 2012-12-31 | $101,157,535 |
Participant contributions at end of year | 2012-12-31 | $3,892,633 |
Participant contributions at beginning of year | 2012-12-31 | $1,858,779 |
Assets. Other investments not covered elsewhere at end of year | 2012-12-31 | $5,000 |
Assets. Other investments not covered elsewhere at beginning of year | 2012-12-31 | $5,000 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $845,743 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $3,439,871 |
Administrative expenses (other) incurred | 2012-12-31 | $942,823 |
Total non interest bearing cash at end of year | 2012-12-31 | $293,525 |
Total non interest bearing cash at beginning of year | 2012-12-31 | $196,733 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Value of net income/loss | 2012-12-31 | $560,621 |
Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $524,806 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $-35,815 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $13,000,000 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $11,900,000 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $11,900,000 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $134 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $56,942,251 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
Contributions received in cash from employer | 2012-12-31 | $209,427,513 |
Employer contributions (assets) at end of year | 2012-12-31 | $4,750,000 |
Employer contributions (assets) at beginning of year | 2012-12-31 | $2,200,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $241,306,292 |
Contract administrator fees | 2012-12-31 | $10,833,195 |
Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $22,262,095 |
Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $19,636,198 |
Did the plan have assets held for investment | 2012-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
Accountancy firm name | 2012-12-31 | PRICEWATERHOUSE COOPERS, LLP |
Accountancy firm EIN | 2012-12-31 | 134008324 |
2011 : ZEBA 2011 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $19,636,198 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $24,311,425 |
Total income from all sources (including contributions) | 2011-12-31 | $296,188,764 |
Total of all expenses incurred | 2011-12-31 | $296,137,089 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $282,601,839 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $296,187,216 |
Value of total assets at end of year | 2011-12-31 | $19,600,383 |
Value of total assets at beginning of year | 2011-12-31 | $24,223,935 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $13,535,250 |
Total interest from all sources | 2011-12-31 | $1,548 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
Value of fidelity bond cover | 2011-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
Contributions received from participants | 2011-12-31 | $97,759,821 |
Participant contributions at end of year | 2011-12-31 | $1,858,779 |
Participant contributions at beginning of year | 2011-12-31 | $1,813,000 |
Assets. Other investments not covered elsewhere at end of year | 2011-12-31 | $5,000 |
Assets. Other investments not covered elsewhere at beginning of year | 2011-12-31 | $5,000 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $3,439,871 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $1,671,485 |
Administrative expenses (other) incurred | 2011-12-31 | $993,515 |
Total non interest bearing cash at end of year | 2011-12-31 | $196,733 |
Total non interest bearing cash at beginning of year | 2011-12-31 | $334,450 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Value of net income/loss | 2011-12-31 | $51,675 |
Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $-35,815 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $-87,490 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $11,900,000 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $12,000,000 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $12,000,000 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $1,548 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $54,502,386 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
Contributions received in cash from employer | 2011-12-31 | $198,427,395 |
Employer contributions (assets) at end of year | 2011-12-31 | $2,200,000 |
Employer contributions (assets) at beginning of year | 2011-12-31 | $8,400,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $228,099,453 |
Contract administrator fees | 2011-12-31 | $12,541,735 |
Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $19,636,198 |
Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $24,311,425 |
Did the plan have assets held for investment | 2011-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
Accountancy firm name | 2011-12-31 | PRICEWATERHOUSE COOPERS, LLP |
Accountancy firm EIN | 2011-12-31 | 134008324 |
2010 : ZEBA 2010 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $24,311,425 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $24,136,528 |
Total income from all sources (including contributions) | 2010-12-31 | $300,559,544 |
Total of all expenses incurred | 2010-12-31 | $300,570,323 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $287,148,421 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $300,558,706 |
Value of total assets at end of year | 2010-12-31 | $24,223,935 |
Value of total assets at beginning of year | 2010-12-31 | $24,059,817 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $13,421,902 |
Total interest from all sources | 2010-12-31 | $838 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
Value of fidelity bond cover | 2010-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
Contributions received from participants | 2010-12-31 | $93,548,973 |
Participant contributions at end of year | 2010-12-31 | $1,813,000 |
Participant contributions at beginning of year | 2010-12-31 | $3,358,557 |
Assets. Other investments not covered elsewhere at end of year | 2010-12-31 | $5,000 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $1,671,485 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $738,545 |
Administrative expenses (other) incurred | 2010-12-31 | $477,379 |
Total non interest bearing cash at end of year | 2010-12-31 | $334,450 |
Total non interest bearing cash at beginning of year | 2010-12-31 | $212,715 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Value of net income/loss | 2010-12-31 | $-10,779 |
Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $-87,490 |
Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $-76,711 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $12,000,000 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $10,000,000 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $10,000,000 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $838 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $53,224,841 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
Contributions received in cash from employer | 2010-12-31 | $207,009,733 |
Employer contributions (assets) at end of year | 2010-12-31 | $8,400,000 |
Employer contributions (assets) at beginning of year | 2010-12-31 | $9,750,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $233,923,580 |
Contract administrator fees | 2010-12-31 | $12,944,523 |
Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $24,311,425 |
Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $24,136,528 |
Did the plan have assets held for investment | 2010-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
Accountancy firm name | 2010-12-31 | PRICEWATERHOUSE COOPERS, LLP |
Accountancy firm EIN | 2010-12-31 | 134008324 |
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 6 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1564 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,163,016 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 9 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 84429 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,021 | Total amount of fees paid to insurance company | USD $129,718 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,658,554 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,021 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 129718 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10104051001 |
Policy instance | 8 |
Insurance contract or identification number | 10104051001 | Number of Individuals Covered | 372 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,931 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98166611001 |
Policy instance | 7 |
Insurance contract or identification number | 98166611001 | Number of Individuals Covered | 75696 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,950,171 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | W13140 |
Policy instance | 1 |
Insurance contract or identification number | W13140 | Number of Individuals Covered | 513 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $24,109 | Total amount of fees paid to insurance company | USD $41 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,108,956 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,109 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 41 | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, COMMUNICATION, AND TRAINING |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 5 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 838 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,245,364 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 4 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 156 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $26,470 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $668,714 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,470 | Insurance broker organization code? | 3 |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 10106140 |
Policy instance | 3 |
Insurance contract or identification number | 10106140 | Number of Individuals Covered | 1430 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $109,643 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,309,556 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $109,643 |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 2 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 80774 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $26,646 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,947,920 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,646 | Insurance broker organization code? | 3 |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 10 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 44290 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,979 | Total amount of fees paid to insurance company | USD $191,202 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,858,289 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,979 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 191202 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 11 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 338 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,979,932 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | W13139 |
Policy instance | 19 |
Insurance contract or identification number | W13139 | Number of Individuals Covered | 1461 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $107,980 | Total amount of fees paid to insurance company | USD $142 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,082,403 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $107,980 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 142 | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, COMMUNICATIO AND TRAINING |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU-4379556 |
Policy instance | 18 |
Insurance contract or identification number | GTU-4379556 | Number of Individuals Covered | 25196 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $39,155 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $783,097 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,155 |
|
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP0009120882-A |
Policy instance | 17 |
Insurance contract or identification number | GTP0009120882-A | Number of Individuals Covered | 20000 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $4,305 | Other welfare benefits provided | TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $17,219 | Commission paid to Insurance Broker | USD $4,305 | Insurance broker organization code? | 3 |
|
CMG ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 52512 ) |
Policy contract number | |
Policy instance | 16 |
Number of Individuals Covered | 262171 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $820,212 |
|
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0835433HNO |
Policy instance | 15 |
Insurance contract or identification number | 0835433HNO | Number of Individuals Covered | 403 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $57,531 | Total amount of fees paid to insurance company | USD $153 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,244,473 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $57,531 | Amount paid for insurance broker fees | 153 | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | Insurance broker organization code? | 3 |
|
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 ) |
Policy contract number | CLPEX01050 |
Policy instance | 14 |
Insurance contract or identification number | CLPEX01050 | Number of Individuals Covered | 24521 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $251,266 | Total amount of fees paid to insurance company | USD $164,854 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,096,173 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $251,266 | Amount paid for insurance broker fees | 164854 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 13 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 281 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,848,916 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 12 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 162 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $971,831 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 10106140 |
Policy instance | 3 |
Insurance contract or identification number | 10106140 | Number of Individuals Covered | 1479 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $111,335 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,422,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $111,335 | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 2 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 82747 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $26,879 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $28,397,463 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,879 | Insurance broker organization code? | 3 |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | W13140 |
Policy instance | 1 |
Insurance contract or identification number | W13140 | Number of Individuals Covered | 559 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $29,659 | Total amount of fees paid to insurance company | USD $57 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,944,010 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,659 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 57 | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, COMMUNICATION, AND TRAINING |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | W13139 |
Policy instance | 19 |
Insurance contract or identification number | W13139 | Number of Individuals Covered | 1675 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $138,547 | Total amount of fees paid to insurance company | USD $75 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,642,397 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $138,547 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 75 | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, COMMUNICATION, AND TRAINING |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU-4379556 |
Policy instance | 18 |
Insurance contract or identification number | GTU-4379556 | Number of Individuals Covered | 25107 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $39,105 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $782,094 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,105 |
|
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP0009120882-A |
Policy instance | 17 |
Insurance contract or identification number | GTP0009120882-A | Number of Individuals Covered | 8800 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-09-30 | Total amount of commissions paid to insurance broker | USD $4,305 | Other welfare benefits provided | TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $17,219 | Commission paid to Insurance Broker | USD $4,305 | Insurance broker organization code? | 3 |
|
CMG ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 52512 ) |
Policy contract number | |
Policy instance | 16 |
Number of Individuals Covered | 267675 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $727,931 |
|
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0835433HNO |
Policy instance | 15 |
Insurance contract or identification number | 0835433HNO | Number of Individuals Covered | 432 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $58,456 | Total amount of fees paid to insurance company | USD $23 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,261,060 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $58,456 | Amount paid for insurance broker fees | 23 | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | Insurance broker organization code? | 3 |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 4 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 138 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $26,778 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $666,098 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,778 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 12 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 160 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,126,874 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 ) |
Policy contract number | CLPEX01050 |
Policy instance | 14 |
Insurance contract or identification number | CLPEX01050 | Number of Individuals Covered | 24445 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $193,934 | Total amount of fees paid to insurance company | USD $139,831 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,494,480 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $193,934 | Amount paid for insurance broker fees | 139831 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 13 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 354 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,014,823 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 11 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 348 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,083,701 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 10 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 44477 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,070 | Total amount of fees paid to insurance company | USD $185,368 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,367,498 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,070 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 185368 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 9 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 89547 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,930 | Total amount of fees paid to insurance company | USD $116,557 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,385,823 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,930 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 116557 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10104051001 |
Policy instance | 8 |
Insurance contract or identification number | 10104051001 | Number of Individuals Covered | 380 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,888 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98166611001 |
Policy instance | 7 |
Insurance contract or identification number | 98166611001 | Number of Individuals Covered | 76877 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,374,886 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 6 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1600 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,753,057 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 5 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 939 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,597,012 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10104051001 |
Policy instance | 8 |
Insurance contract or identification number | 10104051001 | Number of Individuals Covered | 287 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,674 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 9 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 86769 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,742 | Total amount of fees paid to insurance company | USD $95,019 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,472,052 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,742 | Amount paid for insurance broker fees | 95019 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 10 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 44236 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,258 | Total amount of fees paid to insurance company | USD $177,656 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,940,900 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,258 | Amount paid for insurance broker fees | 177656 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | W13140 |
Policy instance | 1 |
Insurance contract or identification number | W13140 | Number of Individuals Covered | 539 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $15,230 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,552,270 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,230 | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98166611001 |
Policy instance | 7 |
Insurance contract or identification number | 98166611001 | Number of Individuals Covered | 75721 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,827,458 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 6 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1546 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,122,471 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 5 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 877 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,013,706 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 4 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 157 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $27,059 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $675,654 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,059 | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 2 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 82671 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $25,555 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $26,064,411 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,555 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 11 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 394 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,357,429 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 12 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 187 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $992,103 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 10106140 |
Policy instance | 3 |
Insurance contract or identification number | 10106140 | Number of Individuals Covered | 1563 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $109,620 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,307,986 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $109,620 | Insurance broker organization code? | 3 |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 00235382 |
Policy instance | 21 |
Insurance contract or identification number | 00235382 | Number of Individuals Covered | 1960 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $76,081 | Total amount of fees paid to insurance company | USD $167 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,827,069 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 167 | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, COMMUNICATION AND TRAINING | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $76,081 |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 00235391 |
Policy instance | 20 |
Insurance contract or identification number | 00235391 | Number of Individuals Covered | 662 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $610 | Total amount of fees paid to insurance company | USD $18,555 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,234,012 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 47 | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, COMMUNICATION AND TRAINING | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $610 |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | W13139 |
Policy instance | 19 |
Insurance contract or identification number | W13139 | Number of Individuals Covered | 1563 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $51,567 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,496,688 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $51,567 | Insurance broker organization code? | 3 |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU-4379556 |
Policy instance | 18 |
Insurance contract or identification number | GTU-4379556 | Number of Individuals Covered | 24195 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $38,573 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $771,453 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $38,573 | Insurance broker organization code? | 3 |
|
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP0009120882-A |
Policy instance | 17 |
Insurance contract or identification number | GTP0009120882-A | Number of Individuals Covered | 8800 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $4,305 | Other welfare benefits provided | TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $17,219 | Commission paid to Insurance Broker | USD $4,305 | Insurance broker organization code? | 3 |
|
CMG ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 52512 ) |
Policy contract number | |
Policy instance | 16 |
Number of Individuals Covered | 259457 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $730,969 |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0835433HNO |
Policy instance | 15 |
Insurance contract or identification number | 0835433HNO | Number of Individuals Covered | 479 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $57,117 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,218,494 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $57,117 |
|
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 ) |
Policy contract number | CLPEX01050 |
Policy instance | 14 |
Insurance contract or identification number | CLPEX01050 | Number of Individuals Covered | 23139 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $214,572 | Total amount of fees paid to insurance company | USD $126,387 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,152,399 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $214,572 | Amount paid for insurance broker fees | 126387 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 13 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 276 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,923,930 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 11 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 378 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,130,610 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 12 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 182 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,127,746 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 13 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 270 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-07-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,274,554 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 ) |
Policy contract number | CLPEX01050 |
Policy instance | 14 |
Insurance contract or identification number | CLPEX01050 | Number of Individuals Covered | 22092 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $192,942 | Total amount of fees paid to insurance company | USD $124,766 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,367,136 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $192,942 | Amount paid for insurance broker fees | 124766 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
|
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0835433HNO |
Policy instance | 15 |
Insurance contract or identification number | 0835433HNO | Number of Individuals Covered | 494 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $55,801 | Total amount of fees paid to insurance company | USD $82 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,133,824 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 82 | Commission paid to Insurance Broker | USD $55,801 |
|
CMG ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 52512 ) |
Policy contract number | |
Policy instance | 16 |
Number of Individuals Covered | 235981 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $645,293 |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP0009120882-A |
Policy instance | 17 |
Insurance contract or identification number | GTP0009120882-A | Number of Individuals Covered | 8800 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-09-30 | Total amount of commissions paid to insurance broker | USD $4,305 | Other welfare benefits provided | TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $17,219 | Commission paid to Insurance Broker | USD $4,305 | Insurance broker organization code? | 3 |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 10 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 43181 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $3,224 | Total amount of fees paid to insurance company | USD $160,112 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,403,983 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,224 | Amount paid for insurance broker fees | 160112 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10104051001 |
Policy instance | 8 |
Insurance contract or identification number | 10104051001 | Number of Individuals Covered | 298 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,008 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98166611001 |
Policy instance | 7 |
Insurance contract or identification number | 98166611001 | Number of Individuals Covered | 73506 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,523,938 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 6 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1491 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,973,872 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 5 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 850 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,727,289 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 4 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 163 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $27,679 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $693,486 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,679 | Insurance broker organization code? | 3 |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 10106140 |
Policy instance | 3 |
Insurance contract or identification number | 10106140 | Number of Individuals Covered | 1674 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $106,420 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,094,660 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $106,420 | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 2 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 79365 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $24,517 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,001,611 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,517 | Insurance broker organization code? | 3 |
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ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 001007097 |
Policy instance | 1 |
Insurance contract or identification number | 001007097 | Number of Individuals Covered | 3818 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $155,950 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,864,223 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $155,950 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU-4379556 |
Policy instance | 18 |
Insurance contract or identification number | GTU-4379556 | Number of Individuals Covered | 24177 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $40,892 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $817,841 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,892 | Amount paid for insurance broker fees | 0 |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 9 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 74312 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,776 | Total amount of fees paid to insurance company | USD $88,196 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,627,428 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,776 | Amount paid for insurance broker fees | 88196 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 7 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1522 | Insurance policy start date | 2017-08-01 | Insurance policy end date | 2018-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,571,112 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 14 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 398 | Insurance policy start date | 2017-08-01 | Insurance policy end date | 2018-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,069,961 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 15 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 188 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $990,843 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 16 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 188 | Insurance policy start date | 2017-08-01 | Insurance policy end date | 2018-07-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,023,836 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 299992P |
Policy instance | 4 |
Insurance contract or identification number | 299992P | Number of Individuals Covered | 495 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $2,386 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,343 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,352 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU-4379556 |
Policy instance | 17 |
Insurance contract or identification number | GTU-4379556 | Number of Individuals Covered | 21487 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $42,618 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $852,362 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $42,618 | Amount paid for insurance broker fees | 0 |
|
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 ) |
Policy contract number | CLPEX01050 |
Policy instance | 18 |
Insurance contract or identification number | CLPEX01050 | Number of Individuals Covered | 20884 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $176,216 | Total amount of fees paid to insurance company | USD $177,980 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,988,471 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $176,216 | Amount paid for insurance broker fees | 177980 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
|
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0835433HNO |
Policy instance | 19 |
Insurance contract or identification number | 0835433HNO | Number of Individuals Covered | 510 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $57,162 | Total amount of fees paid to insurance company | USD $82 | Welfare Benefit Premiums Paid to Carrier | USD $3,197,513 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 82 | Commission paid to Insurance Broker | USD $57,162 |
|
CMG ASSOCIATES (National Association of Insurance Commissioners NAIC id number: 52512 ) |
Policy contract number | |
Policy instance | 20 |
Number of Individuals Covered | 227204 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $552,597 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP0009120882-A |
Policy instance | 21 |
Insurance contract or identification number | GTP0009120882-A | Number of Individuals Covered | 8800 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-09-30 | Total amount of commissions paid to insurance broker | USD $4,305 | Other welfare benefits provided | TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $17,219 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,305 | Insurance broker organization code? | 3 |
|
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
Policy contract number | GF381026130001 |
Policy instance | 13 |
Insurance contract or identification number | GF381026130001 | Number of Individuals Covered | 8596 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $20,940 | Other welfare benefits provided | STATE DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $740,311 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,940 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
|
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
Policy contract number | GF381026130001 |
Policy instance | 12 |
Insurance contract or identification number | GF381026130001 | Number of Individuals Covered | 16905 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $56,406 | Other welfare benefits provided | STATE DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $531,585 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $56,406 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 |
Policy instance | 3 |
Insurance contract or identification number | 106140 | Number of Individuals Covered | 1674 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $121,557 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,103,832 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $121,557 | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 2 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 76713 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $23,029 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,807,490 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,029 | Insurance broker organization code? | 3 |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 001007097 |
Policy instance | 1 |
Insurance contract or identification number | 001007097 | Number of Individuals Covered | 2499 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $144,545 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,169,506 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,513 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 5 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 172 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $26,610 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $666,290 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,610 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 6 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 812 | Insurance policy start date | 2017-08-01 | Insurance policy end date | 2018-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,883,156 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98166611001 |
Policy instance | 8 |
Insurance contract or identification number | 98166611001 | Number of Individuals Covered | 69573 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,945,523 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10104051001 |
Policy instance | 9 |
Insurance contract or identification number | 10104051001 | Number of Individuals Covered | 297 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,891 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 10 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 70095 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,594 | Total amount of fees paid to insurance company | USD $71,031 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,337,952 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,594 | Amount paid for insurance broker fees | 71031 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 11 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 42371 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $3,406 | Total amount of fees paid to insurance company | USD $151,705 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,131,716 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,406 | Amount paid for insurance broker fees | 151705 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 12 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 63718 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,563 | Total amount of fees paid to insurance company | USD $63,394 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,924,703 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,563 | Amount paid for insurance broker fees | 63394 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES BENEFITS |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 34214 |
Policy instance | 11 |
Insurance contract or identification number | 34214 | Number of Individuals Covered | 0 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 99134841001 |
Policy instance | 10 |
Insurance contract or identification number | 99134841001 | Number of Individuals Covered | 0 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,067 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98166611001 |
Policy instance | 9 |
Insurance contract or identification number | 98166611001 | Number of Individuals Covered | 65651 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,245,479 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 8 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1438 | Insurance policy start date | 2016-08-01 | Insurance policy end date | 2017-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,337,681 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 7 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 834 | Insurance policy start date | 2016-08-01 | Insurance policy end date | 2017-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,271,371 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 6 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 179 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $26,551 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $664,215 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,551 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF MASSCHUSETTS LLC |
|
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
Policy contract number | 70125 |
Policy instance | 13 |
Insurance contract or identification number | 70125 | Number of Individuals Covered | 41758 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,427 | Total amount of fees paid to insurance company | USD $139,466 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,434,431 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,427 | Amount paid for insurance broker fees | 139466 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES BENEFITS |
|
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
Policy contract number | GF381026130001 |
Policy instance | 14 |
Insurance contract or identification number | GF381026130001 | Number of Individuals Covered | 13882 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $116,235 | Total amount of fees paid to insurance company | USD $85,901 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,029,732 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $116,235 | Amount paid for insurance broker fees | 85901 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES BENEFIT ADVISORS |
|
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
Policy contract number | GF381026130001 |
Policy instance | 15 |
Insurance contract or identification number | GF381026130001 | Number of Individuals Covered | 8435 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $33,633 | Total amount of fees paid to insurance company | USD $7,386 | Other welfare benefits provided | STATE DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $690,328 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,633 | Amount paid for insurance broker fees | 7386 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF MASSACHUSETTS LLC |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 16 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 377 | Insurance policy start date | 2016-08-01 | Insurance policy end date | 2017-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,471,623 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 17 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 183 | Insurance policy start date | 2016-06-01 | Insurance policy end date | 2017-05-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,094,167 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 18 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 157 | Insurance policy start date | 2016-08-01 | Insurance policy end date | 2017-07-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $711,667 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU-4379556 |
Policy instance | 19 |
Insurance contract or identification number | GTU-4379556 | Number of Individuals Covered | 23697 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $41,902 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $838,040 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,902 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY, INC. |
|
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 ) |
Policy contract number | CLPEX01050 |
Policy instance | 20 |
Insurance contract or identification number | CLPEX01050 | Number of Individuals Covered | 19376 | Insurance policy start date | 2017-08-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $56,713 | Total amount of fees paid to insurance company | USD $42,483 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,364,259 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $56,713 | Amount paid for insurance broker fees | 42483 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker name | PACIFIC RESOURCES BENEFITS ADVISORS |
|
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0835433HNO |
Policy instance | 21 |
Insurance contract or identification number | 0835433HNO | Number of Individuals Covered | 592 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $55,179 | Welfare Benefit Premiums Paid to Carrier | USD $3,366,027 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,743 | Insurance broker name | BROWN & BROWN OF MASSACHUSETTS |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 299992P |
Policy instance | 5 |
Insurance contract or identification number | 299992P | Number of Individuals Covered | 409 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,346 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $46,373 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,346 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT & INS |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 |
Policy instance | 4 |
Insurance contract or identification number | 106140 | Number of Individuals Covered | 1816 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $94,109 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,273,924 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $94,109 | Insurance broker organization code? | 3 | Insurance broker name | STRATEGIC BENEFIT ADVISORS INC. |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 3 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 72455 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $21,784 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $26,229,292 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,784 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 001007097 |
Policy instance | 2 |
Insurance contract or identification number | 001007097 | Number of Individuals Covered | 2574 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $241,801 | Total amount of fees paid to insurance company | USD $482 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,644,945 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $241,801 | Amount paid for insurance broker fees | 482 | Insurance broker organization code? | 3 | Insurance broker name | ASSUREDPARTNERS NL LLC |
|
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
Policy contract number | GF381026130001 |
Policy instance | 1 |
Insurance contract or identification number | GF381026130001 | Number of Individuals Covered | 15049 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $24,736 | Total amount of fees paid to insurance company | USD $4,871 | Other welfare benefits provided | STATE DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $501,906 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,736 | Amount paid for insurance broker fees | 4871 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF MASSACHUSETTS LLC |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 7 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 174 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $841,531 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU 4379556 |
Policy instance | 8 |
Insurance contract or identification number | GTU 4379556 | Number of Individuals Covered | 22458 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $21,280 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $709,328 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,280 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 299992P |
Policy instance | 9 |
Insurance contract or identification number | 299992P | Number of Individuals Covered | 395 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $2,129 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,842 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,129 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT & INS |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 10 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 67324 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $20,149 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,850,476 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,149 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9816661 |
Policy instance | 11 |
Insurance contract or identification number | 9816661 | Number of Individuals Covered | 57079 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,731,949 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 00235382 |
Policy instance | 12 |
Insurance contract or identification number | 00235382 | Number of Individuals Covered | 1406 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $139,423 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,418,371 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $139,423 | Insurance broker organization code? | 3 | Insurance broker name | ASSURED PARTNERS NL |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 13 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 115 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $445,449 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 34214 |
Policy instance | 16 |
Insurance contract or identification number | 34214 | Number of Individuals Covered | 39835 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $3,275 | Total amount of fees paid to insurance company | USD $101,104 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,853,901 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,275 | Amount paid for insurance broker fees | 101104 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES BENEFITS |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649363 |
Policy instance | 14 |
Insurance contract or identification number | 649363 | Number of Individuals Covered | 7684 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $6,935 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $511,070 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,793 | Insurance broker organization code? | 3 | Insurance broker name | STRATEGIC BENEFIT ADVISORS INC. |
|
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649364 |
Policy instance | 15 |
Insurance contract or identification number | 649364 | Number of Individuals Covered | 11934 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $5,658 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $319,698 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,658 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT & INS |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 34214 |
Policy instance | 17 |
Insurance contract or identification number | 34214 | Number of Individuals Covered | 54688 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,725 | Total amount of fees paid to insurance company | USD $53,254 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,355,216 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,725 | Amount paid for insurance broker fees | 53254 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES BENEFITS |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9913484 |
Policy instance | 18 |
Insurance contract or identification number | 9913484 | Number of Individuals Covered | 1143 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $54,120 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 6 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 404 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,775,986 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 5 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 819 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,680,692 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 4 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1308 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,720,308 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 |
Policy instance | 3 |
Insurance contract or identification number | 106140 | Number of Individuals Covered | 1687 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $91,832 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,122,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $49,447 | Insurance broker organization code? | 3 | Insurance broker name | STRATEGIC BENEFIT ADVISORS, INC. |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 2 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 180 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $18,280 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $554,777 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,403 | Insurance broker organization code? | 3 | Insurance broker name | ASSURED NL INS AGENCY INC |
|
COVENTRY HEALTH CARE OF CAROLINAS, INC. (National Association of Insurance Commissioners NAIC id number: 95321 ) |
Policy contract number | 3130090000 |
Policy instance | 1 |
Insurance contract or identification number | 3130090000 | Number of Individuals Covered | 713 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $58,481 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,341,797 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,761 | Insurance broker organization code? | 3 | Insurance broker name | ASSURED NL INSURANCE AGENCY, INC. |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 00235382 |
Policy instance | 14 |
Insurance contract or identification number | 00235382 | Number of Individuals Covered | 1513 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $165,822 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,163,284 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $165,822 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF INDIANA LLC |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9673823 |
Policy instance | 12 |
Insurance contract or identification number | 9673823 | Number of Individuals Covered | 691 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,637 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 10 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 66216 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $21,629 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,549,001 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,629 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 675896G |
Policy instance | 9 |
Insurance contract or identification number | 675896G | Number of Individuals Covered | 13203 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of fees paid to insurance company | USD $2,444 | 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 | Amount paid for insurance broker fees | 2444 | Additional information about fees paid to insurance broker | BONUS PAID | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES SPECIAL RISK INS |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 15 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 128 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $775,410 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9816661 |
Policy instance | 13 |
Insurance contract or identification number | 9816661 | Number of Individuals Covered | 54767 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,426,616 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9913484 |
Policy instance | 11 |
Insurance contract or identification number | 9913484 | Number of Individuals Covered | 1093 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,130 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649364 |
Policy instance | 18 |
Insurance contract or identification number | 649364 | Number of Individuals Covered | 12477 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $7,179 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $418,581 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,179 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT & INS |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 34214 |
Policy instance | 19 |
Insurance contract or identification number | 34214 | Number of Individuals Covered | 39152 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $3,265 | Total amount of fees paid to insurance company | USD $93,762 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,920,568 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,265 | Amount paid for insurance broker fees | 93762 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES BENEFITS |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 34214 |
Policy instance | 20 |
Insurance contract or identification number | 34214 | Number of Individuals Covered | 51659 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $1,735 | Total amount of fees paid to insurance company | USD $49,825 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,164,404 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,735 | Amount paid for insurance broker fees | 49825 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES BENEFITS |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU 4379556 |
Policy instance | 8 |
Insurance contract or identification number | GTU 4379556 | Number of Individuals Covered | 22682 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $17,919 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $597,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,919 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 7 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 199 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $840,334 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 6 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 413 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,907,087 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 5 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 854 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,665,283 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 4 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1297 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,441,728 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 2 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 187 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $24,619 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $608,361 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,619 | Insurance broker organization code? | 3 | Insurance broker name | NEACE LUKENS - ASSURED PARTNERS CO |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 |
Policy instance | 3 |
Insurance contract or identification number | 106140 | Number of Individuals Covered | 1691 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $88,217 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,881,100 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $88,217 | Insurance broker organization code? | 3 | Insurance broker name | PATTY MCGOWAN |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649363 |
Policy instance | 17 |
Insurance contract or identification number | 649363 | Number of Individuals Covered | 6377 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $6,677 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $470,504 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,677 | Insurance broker organization code? | 3 | Insurance broker name | EDWARD L KANE |
|
COVENTRY HEALTH CARE OF CAROLINAS, INC. (National Association of Insurance Commissioners NAIC id number: 95321 ) |
Policy contract number | 3130090000 |
Policy instance | 1 |
Insurance contract or identification number | 3130090000 | Number of Individuals Covered | 783 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $56,233 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,503,758 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $56,233 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF SOUTHWEST IN INC. |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 299992P |
Policy instance | 16 |
Insurance contract or identification number | 299992P | Number of Individuals Covered | 233 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $2,094 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,968 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,094 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT & INS |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 53-66-587 |
Policy instance | 9 |
Insurance contract or identification number | 53-66-587 | Number of Individuals Covered | 32096 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-03-31 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $98,214 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT ADVISORS, INC. |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 11 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 64927 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $19,139 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,764,535 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,139 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU 4379556 |
Policy instance | 8 |
Insurance contract or identification number | GTU 4379556 | Number of Individuals Covered | 22605 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $27,067 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $541,345 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,067 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 7 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 200 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $827,435 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 6 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 439 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,877,121 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 4 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1248 | Insurance policy start date | 2012-08-01 | Insurance policy end date | 2013-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,245,659 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 |
Policy instance | 3 |
Insurance contract or identification number | 106140 | Number of Individuals Covered | 1603 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $69,807 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,653,820 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $69,807 | Insurance broker organization code? | 3 | Insurance broker name | PATTY MCGOWAN |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 2 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 209 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $9,208 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $675,445 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,208 | Insurance broker organization code? | 3 | Insurance broker name | PATRICIA MCGOWAN |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 5 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 823 | Insurance policy start date | 2012-08-01 | Insurance policy end date | 2013-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,574,231 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9673823 |
Policy instance | 12 |
Insurance contract or identification number | 9673823 | Number of Individuals Covered | 1149 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $92,547 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 34214 |
Policy instance | 21 |
Insurance contract or identification number | 34214 | Number of Individuals Covered | 49102 | Insurance policy start date | 2013-08-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $19,880 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $854,582 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,880 | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES BENEFITS |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 34214 |
Policy instance | 22 |
Insurance contract or identification number | 34214 | Number of Individuals Covered | 38118 | Insurance policy start date | 2013-08-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $41,478 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,645,488 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,478 | Insurance broker organization code? | 3 | Insurance broker name | PACIFIC RESOURCES BENEFITS |
|
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649364 |
Policy instance | 20 |
Insurance contract or identification number | 649364 | Number of Individuals Covered | 11991 | Insurance policy start date | 2013-04-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,907 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $298,572 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,907 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT & INS |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649363 |
Policy instance | 19 |
Insurance contract or identification number | 649363 | Number of Individuals Covered | 7199 | Insurance policy start date | 2013-04-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,377 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $201,668 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,377 | Insurance broker organization code? | 3 | Insurance broker name | EDWARD L KANE |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 299992P |
Policy instance | 18 |
Insurance contract or identification number | 299992P | Number of Individuals Covered | 237 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $2,100 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,161 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,100 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT & INS |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 00235382 |
Policy instance | 16 |
Insurance contract or identification number | 00235382 | Number of Individuals Covered | 1604 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $179,989 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,185,602 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $179,989 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF INDIANA LLC |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 17 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 163 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-01 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $746,806 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9816661 |
Policy instance | 15 |
Insurance contract or identification number | 9816661 | Number of Individuals Covered | 50853 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,045,897 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 7993242 |
Policy instance | 14 |
Insurance contract or identification number | 7993242 | Number of Individuals Covered | 6774 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-03-31 | Total amount of commissions paid to insurance broker | USD $2,090 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $149,313 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,090 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT ADVISORS INC. |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9673831 |
Policy instance | 13 |
Insurance contract or identification number | 9673831 | Number of Individuals Covered | 11113 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,258 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
COVENTRY HEALTH CARE OF CAROLINAS, INC. (National Association of Insurance Commissioners NAIC id number: 95321 ) |
Policy contract number | 3130090000 |
Policy instance | 1 |
Insurance contract or identification number | 3130090000 | Number of Individuals Covered | 838 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $62,806 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,554,863 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $62,806 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF SOUTHWEST IN INC. |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 395129G |
Policy instance | 10 |
Insurance contract or identification number | 395129G | Number of Individuals Covered | 56743 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,134,822 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY, INC. |
|
COVENTRY HEALTH CARE OF CAROLINAS, INC. (National Association of Insurance Commissioners NAIC id number: 95321 ) |
Policy contract number | 3130090000 |
Policy instance | 1 |
Insurance contract or identification number | 3130090000 | Number of Individuals Covered | 383 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $64,829 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,536,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $64,829 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF SOUTHWEST IN INC. |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 53-66-587 |
Policy instance | 10 |
Insurance contract or identification number | 53-66-587 | Number of Individuals Covered | 11050 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $392,016 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT ADVISORS, INC. |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 12 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 31510 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $18,760 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,589,785 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,760 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9673823 |
Policy instance | 13 |
Insurance contract or identification number | 9673823 | Number of Individuals Covered | 3533 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $165,246 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9673831 |
Policy instance | 14 |
Insurance contract or identification number | 9673831 | Number of Individuals Covered | 11211 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $63,474 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9816661 |
Policy instance | 16 |
Insurance contract or identification number | 9816661 | Number of Individuals Covered | 39814 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,699,148 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 7993452 |
Policy instance | 17 |
Insurance contract or identification number | 7993452 | Number of Individuals Covered | 50 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,260 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,439 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,260 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT & INSURANCE |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 00235382 |
Policy instance | 18 |
Insurance contract or identification number | 00235382 | Number of Individuals Covered | 824 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $61,931 | Total amount of fees paid to insurance company | USD $12,500 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,333,036 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $61,931 | Amount paid for insurance broker fees | 12500 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF INDIANA LLC |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 6500 |
Policy instance | 19 |
Insurance contract or identification number | 6500 | Number of Individuals Covered | 174 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $447,542 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 395129G |
Policy instance | 11 |
Insurance contract or identification number | 395129G | Number of Individuals Covered | 81057 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $5,000 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,044,385 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,000 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY, INC. |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU 4379556 |
Policy instance | 9 |
Insurance contract or identification number | GTU 4379556 | Number of Individuals Covered | 22912 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $26,564 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $531,289 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,564 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 7993242 |
Policy instance | 15 |
Insurance contract or identification number | 7993242 | Number of Individuals Covered | 4684 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,391 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $470,998 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,391 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT & INSURANCE |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 2 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 91 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $26,778 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $667,489 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,778 | Insurance broker organization code? | 3 | Insurance broker name | PATRICIA MCGOWAN |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 |
Policy instance | 3 |
Insurance contract or identification number | 106140 | Number of Individuals Covered | 831 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $71,052 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,736,792 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $71,052 | Insurance broker organization code? | 3 | Insurance broker name | PATTY MCGOWAN |
|
WELBORN HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 12540 ) |
Policy contract number | W9368 |
Policy instance | 4 |
Insurance contract or identification number | W9368 | Number of Individuals Covered | 867 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $91,722 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,705,323 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $91,722 | Insurance broker organization code? | 3 | Insurance broker name | PATTY MCGOWAN |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 7 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 453 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,948,012 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 5 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 1350 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2012-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,781,491 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 6 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 832 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2012-07-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,368,788 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 8 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 198 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $776,114 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 6 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 463 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,929,676 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9673823 |
Policy instance | 13 |
Insurance contract or identification number | 9673823 | Number of Individuals Covered | 5398 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,030,381 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9673831 |
Policy instance | 14 |
Insurance contract or identification number | 9673831 | Number of Individuals Covered | 12833 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $66,216 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 0010 |
Policy instance | 15 |
Insurance contract or identification number | 106140 0010 | Number of Individuals Covered | 259 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $1,771 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $118,053 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 79932242 |
Policy instance | 16 |
Insurance contract or identification number | 79932242 | Number of Individuals Covered | 4874 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $465,328 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9816661 |
Policy instance | 17 |
Insurance contract or identification number | 9816661 | Number of Individuals Covered | 34939 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2011-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $521,418 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 12 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 61055 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $3,232 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,116,435 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 395129G |
Policy instance | 11 |
Insurance contract or identification number | 395129G | Number of Individuals Covered | 80691 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $5,000 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,132,731 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 53-66-587 |
Policy instance | 10 |
Insurance contract or identification number | 53-66-587 | Number of Individuals Covered | 10307 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $424,019 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
COVENTRY HEALTH CARE OF CAROLINAS, INC. (National Association of Insurance Commissioners NAIC id number: 95321 ) |
Policy contract number | 3130090000 |
Policy instance | 1 |
Insurance contract or identification number | 3130090000 | Number of Individuals Covered | 1057 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $80,171 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,008,565 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 2 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 231 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $38,759 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $673,212 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 |
Policy instance | 3 |
Insurance contract or identification number | 106140 | Number of Individuals Covered | 1653 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $70,043 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,794,429 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
WELBORN HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 12540 ) |
Policy contract number | W9368 |
Policy instance | 4 |
Insurance contract or identification number | W9368 | Number of Individuals Covered | 1847 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $165,084 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,751,775 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 5 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 668 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,286,016 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 7 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 260 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,550,463 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 8 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 115 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $649,492 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU 4379556 |
Policy instance | 9 |
Insurance contract or identification number | GTU 4379556 | Number of Individuals Covered | 22628 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $540,437 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 128137 |
Policy instance | 5 |
Insurance contract or identification number | 128137 | Number of Individuals Covered | 734 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,529,238 |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 2174 |
Policy instance | 7 |
Insurance contract or identification number | 2174 | Number of Individuals Covered | 290 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,629,898 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 35963 |
Policy instance | 6 |
Insurance contract or identification number | 35963 | Number of Individuals Covered | 464 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,809,433 |
|
WELBORN HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 12540 ) |
Policy contract number | W9290 |
Policy instance | 4 |
Insurance contract or identification number | W9290 | Number of Individuals Covered | 1799 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $174,235 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,124,148 | Commission paid to Insurance Broker | USD $174,235 | Insurance broker organization code? | 3 | Insurance broker name | PATTY MCGOWAN |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 |
Policy instance | 3 |
Insurance contract or identification number | 106140 | Number of Individuals Covered | 1260 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $57,396 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,826,382 | Commission paid to Insurance Broker | USD $57,396 | Insurance broker organization code? | 3 | Insurance broker name | PATTY MCGOWAN |
|
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
Policy contract number | 10001452 |
Policy instance | 2 |
Insurance contract or identification number | 10001452 | Number of Individuals Covered | 226 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $51,998 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,420,125 | Commission paid to Insurance Broker | USD $51,998 | Insurance broker organization code? | 3 | Insurance broker name | PATRICIA MCGOWAN |
|
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 ) |
Policy contract number | 5511 |
Policy instance | 8 |
Insurance contract or identification number | 5511 | Number of Individuals Covered | 93 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $915,253 |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | GTU 4379556 |
Policy instance | 9 |
Insurance contract or identification number | GTU 4379556 | Number of Individuals Covered | 24071 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $590,832 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 53-66-587 |
Policy instance | 10 |
Insurance contract or identification number | 53-66-587 | Number of Individuals Covered | 10321 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $332,741 | Insurance broker organization code? | 3 | Insurance broker name | 21ST CENTURY BENEFIT ADVISORS, INC. |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 395129G |
Policy instance | 11 |
Insurance contract or identification number | 395129G | Number of Individuals Covered | 82877 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $5,000 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,843,411 | Commission paid to Insurance Broker | USD $5,000 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY, INC. |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4025139 |
Policy instance | 12 |
Insurance contract or identification number | 4025139 | Number of Individuals Covered | 62993 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $41,938 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,678,720 | Commission paid to Insurance Broker | USD $41,938 | Insurance broker organization code? | 3 | Insurance broker name | WELLESLEY INSURANCE AGENCY |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9673823 |
Policy instance | 13 |
Insurance contract or identification number | 9673823 | Number of Individuals Covered | 38438 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,374,349 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9673831 |
Policy instance | 14 |
Insurance contract or identification number | 9673831 | Number of Individuals Covered | 13867 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $76,306 |
|
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 106140 0010 |
Policy instance | 15 |
Insurance contract or identification number | 106140 0010 | Number of Individuals Covered | 257 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $10,195 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $679,679 | Commission paid to Insurance Broker | USD $10,195 | Insurance broker organization code? | 3 | Insurance broker name | PATTY MCGOWAN |
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ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | TDB7993242 |
Policy instance | 16 |
Insurance contract or identification number | TDB7993242 | Number of Individuals Covered | 4684 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $447,418 | Insurance broker name | 21ST CENTURY BENEFIT ADVISORS, INC. |
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COVENTRY HEALTH CARE OF CAROLINAS, INC. (National Association of Insurance Commissioners NAIC id number: 95321 ) |
Policy contract number | 3130090000 |
Policy instance | 1 |
Insurance contract or identification number | 3130090000 | Number of Individuals Covered | 1023 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $76,103 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,805,156 | Commission paid to Insurance Broker | USD $76,103 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF SOUTHWEST IN INC. |
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