AVON CONVALESCENT HOME, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN
401k plan membership statisitcs for AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN
| Measure | Date | Value |
|---|
| 2021: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-11-01 | 207 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-11-01 | 207 |
| Number of retired or separated participants receiving benefits | 2021-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-11-01 | 0 |
| Total of all active and inactive participants | 2021-11-01 | 207 |
| Number of employers contributing to the scheme | 2021-11-01 | 0 |
| 2020: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-11-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-11-01 | 207 |
| Number of retired or separated participants receiving benefits | 2020-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-11-01 | 0 |
| Total of all active and inactive participants | 2020-11-01 | 207 |
| Number of employers contributing to the scheme | 2020-11-01 | 0 |
| 2019: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-11-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-11-01 | 200 |
| Number of retired or separated participants receiving benefits | 2019-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-11-01 | 0 |
| Total of all active and inactive participants | 2019-11-01 | 200 |
| Number of employers contributing to the scheme | 2019-11-01 | 0 |
| 2018: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-11-01 | 214 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 102 |
| Number of retired or separated participants receiving benefits | 2018-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-11-01 | 0 |
| Total of all active and inactive participants | 2018-11-01 | 102 |
| Number of employers contributing to the scheme | 2018-11-01 | 0 |
| 2017: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-11-01 | 212 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 214 |
| Number of retired or separated participants receiving benefits | 2017-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-11-01 | 0 |
| Total of all active and inactive participants | 2017-11-01 | 214 |
| Number of employers contributing to the scheme | 2017-11-01 | 0 |
| 2016: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-11-01 | 227 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 212 |
| Number of retired or separated participants receiving benefits | 2016-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-11-01 | 0 |
| Total of all active and inactive participants | 2016-11-01 | 212 |
| Number of employers contributing to the scheme | 2016-11-01 | 0 |
| 2015: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-11-01 | 227 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-11-01 | 227 |
| Number of retired or separated participants receiving benefits | 2015-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-11-01 | 0 |
| Total of all active and inactive participants | 2015-11-01 | 227 |
| Number of employers contributing to the scheme | 2015-11-01 | 0 |
| 2014: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-11-01 | 243 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-11-01 | 227 |
| Number of retired or separated participants receiving benefits | 2014-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-11-01 | 0 |
| Total of all active and inactive participants | 2014-11-01 | 227 |
| Number of employers contributing to the scheme | 2014-11-01 | 0 |
| 2013: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-11-01 | 242 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-11-01 | 243 |
| Number of retired or separated participants receiving benefits | 2013-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-11-01 | 0 |
| Total of all active and inactive participants | 2013-11-01 | 243 |
| Number of employers contributing to the scheme | 2013-11-01 | 0 |
| Total participants, beginning-of-year | 2013-04-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 242 |
| Number of retired or separated participants receiving benefits | 2013-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-04-01 | 0 |
| Total of all active and inactive participants | 2013-04-01 | 242 |
| Number of employers contributing to the scheme | 2013-04-01 | 0 |
| 2012: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 252 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 134 |
| Number of retired or separated participants receiving benefits | 2012-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-04-01 | 0 |
| Total of all active and inactive participants | 2012-04-01 | 134 |
| Number of employers contributing to the scheme | 2012-04-01 | 0 |
| 2011: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 252 |
| Number of retired or separated participants receiving benefits | 2011-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-04-01 | 0 |
| Total of all active and inactive participants | 2011-04-01 | 252 |
| Number of employers contributing to the scheme | 2011-04-01 | 0 |
| 2010: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-04-01 | 149 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-04-01 | 149 |
| Number of retired or separated participants receiving benefits | 2010-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-04-01 | 0 |
| Total of all active and inactive participants | 2010-04-01 | 149 |
| Number of employers contributing to the scheme | 2010-04-01 | 0 |
| 2021: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2021 form 5500 responses |
|---|
| 2021-11-01 | Type of plan entity | Single employer plan |
| 2021-11-01 | Plan funding arrangement – Insurance | Yes |
| 2021-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2020 form 5500 responses |
|---|
| 2020-11-01 | Type of plan entity | Single employer plan |
| 2020-11-01 | Plan funding arrangement – Insurance | Yes |
| 2020-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2019 form 5500 responses |
|---|
| 2019-11-01 | Type of plan entity | Single employer plan |
| 2019-11-01 | Plan funding arrangement – Insurance | Yes |
| 2019-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2018 form 5500 responses |
|---|
| 2018-11-01 | Type of plan entity | Single employer plan |
| 2018-11-01 | Plan funding arrangement – Insurance | Yes |
| 2018-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2017 form 5500 responses |
|---|
| 2017-11-01 | Type of plan entity | Single employer plan |
| 2017-11-01 | Plan is a collectively bargained plan | Yes |
| 2017-11-01 | Plan funding arrangement – Insurance | Yes |
| 2017-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2016 form 5500 responses |
|---|
| 2016-11-01 | Type of plan entity | Single employer plan |
| 2016-11-01 | Plan is a collectively bargained plan | Yes |
| 2016-11-01 | Plan funding arrangement – Insurance | Yes |
| 2016-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2015 form 5500 responses |
|---|
| 2015-11-01 | Type of plan entity | Single employer plan |
| 2015-11-01 | Submission has been amended | Yes |
| 2015-11-01 | Plan is a collectively bargained plan | Yes |
| 2015-11-01 | Plan funding arrangement – Insurance | Yes |
| 2015-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2014 form 5500 responses |
|---|
| 2014-11-01 | Type of plan entity | Single employer plan |
| 2014-11-01 | Plan is a collectively bargained plan | Yes |
| 2014-11-01 | Plan funding arrangement – Insurance | Yes |
| 2014-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2013 form 5500 responses |
|---|
| 2013-11-01 | Type of plan entity | Single employer plan |
| 2013-11-01 | Plan funding arrangement – Insurance | Yes |
| 2013-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2013-04-01 | Plan is a collectively bargained plan | Yes |
| 2013-04-01 | Plan funding arrangement – Insurance | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2012 form 5500 responses |
|---|
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Plan is a collectively bargained plan | Yes |
| 2012-04-01 | Plan funding arrangement – Insurance | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Plan is a collectively bargained plan | Yes |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: AVON AND WEST HARTFORD HEALTH CENTERS LIFE/STD/AD&D PLAN 2010 form 5500 responses |
|---|
| 2010-04-01 | Type of plan entity | Single employer plan |
| 2010-04-01 | First time form 5500 has been submitted | Yes |
| 2010-04-01 | Plan is a collectively bargained plan | Yes |
| 2010-04-01 | Plan funding arrangement – Insurance | Yes |
| 2010-04-01 | Plan benefit arrangement – Insurance | Yes |
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 480553 |
| Policy instance | 1 |
| Insurance contract or identification number | 480553 | | Number of Individuals Covered | 207 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 304387 |
| Policy instance | 2 |
| Insurance contract or identification number | 304387 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $7,486 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 304387 |
| Policy instance | 1 |
| Insurance contract or identification number | 304387 | | Number of Individuals Covered | 93 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $97,415 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 304387 |
| Policy instance | 1 |
| Insurance contract or identification number | 304387 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $98,308 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 304387 |
| Policy instance | 1 |
| Insurance contract or identification number | 304387 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $34,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 304387 |
| Policy instance | 1 |
| Insurance contract or identification number | 304387 | | Number of Individuals Covered | 214 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $102,469 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10181384 |
| Policy instance | 1 |
| Insurance contract or identification number | 10181384 | | Number of Individuals Covered | 227 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $4,715 | | Total amount of fees paid to insurance company | USD $2,158 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $81,338 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,715 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10181384 |
| Policy instance | 1 |
| Insurance contract or identification number | 10181384 | | Number of Individuals Covered | 243 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $4,875 | | Total amount of fees paid to insurance company | USD $3,243 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $89,018 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,875 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | MLN00728 |
| Policy instance | 1 |
| Insurance contract or identification number | MLN00728 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $54,797 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | MLN00728 |
| Policy instance | 1 |
| Insurance contract or identification number | MLN00728 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $138 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $92,330 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 69 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | MLN00728 |
| Policy instance | 1 |
| Insurance contract or identification number | MLN00728 | | Number of Individuals Covered | 252 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $162 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $94,179 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 81 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | MLN00728 |
| Policy instance | 1 |
| Insurance contract or identification number | MLN00728 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $170 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $91,060 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 85 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
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