BOARD OF TRUSTEES OF THE UNITED WELFARE FUND has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan UNITED WELFARE FUND-WELFARE DIVISION
| Measure | Date | Value |
|---|
| 2023 : UNITED WELFARE FUND-WELFARE DIVISION 2023 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2023-04-30 | $-407,011 |
| Total unrealized appreciation/depreciation of assets | 2023-04-30 | $-407,011 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-04-30 | $51,113,862 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-04-30 | $55,655,267 |
| Total income from all sources (including contributions) | 2023-04-30 | $180,172,278 |
| Total loss/gain on sale of assets | 2023-04-30 | $1,500 |
| Total of all expenses incurred | 2023-04-30 | $174,844,439 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-04-30 | $164,066,241 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-04-30 | $174,361,301 |
| Value of total assets at end of year | 2023-04-30 | $253,845,139 |
| Value of total assets at beginning of year | 2023-04-30 | $253,058,705 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-04-30 | $10,778,198 |
| Total interest from all sources | 2023-04-30 | $864,213 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-04-30 | $5,187,463 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2023-04-30 | $5,187,463 |
| Administrative expenses professional fees incurred | 2023-04-30 | $765,465 |
| Was this plan covered by a fidelity bond | 2023-04-30 | Yes |
| Value of fidelity bond cover | 2023-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2023-04-30 | No |
| Contributions received from participants | 2023-04-30 | $1,074,720 |
| Participant contributions at end of year | 2023-04-30 | $11,087 |
| Participant contributions at beginning of year | 2023-04-30 | $8,946 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2023-04-30 | $155,314,660 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-04-30 | $4,005,785 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-04-30 | $3,932,232 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-04-30 | $7,149,355 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-04-30 | $2,383,050 |
| Other income not declared elsewhere | 2023-04-30 | $30,075 |
| Administrative expenses (other) incurred | 2023-04-30 | $9,922,127 |
| Liabilities. Value of operating payables at end of year | 2023-04-30 | $1,061,834 |
| Liabilities. Value of operating payables at beginning of year | 2023-04-30 | $527,018 |
| Total non interest bearing cash at end of year | 2023-04-30 | $465,700 |
| Total non interest bearing cash at beginning of year | 2023-04-30 | $386,436 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-04-30 | No |
| Value of net income/loss | 2023-04-30 | $5,327,839 |
| Value of net assets at end of year (total assets less liabilities) | 2023-04-30 | $202,731,277 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-04-30 | $197,403,438 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-04-30 | No |
| Investment advisory and management fees | 2023-04-30 | $90,606 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2023-04-30 | $184,641,824 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2023-04-30 | $189,522,222 |
| Income. Interest from US Government securities | 2023-04-30 | $604,351 |
| Income. Interest from corporate debt instruments | 2023-04-30 | $259,862 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-04-30 | $8,751,581 |
| Asset value of US Government securities at end of year | 2023-04-30 | $46,061,892 |
| Asset value of US Government securities at beginning of year | 2023-04-30 | $45,367,924 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2023-04-30 | $134,737 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-04-30 | No |
| Contributions received in cash from employer | 2023-04-30 | $173,286,581 |
| Employer contributions (assets) at end of year | 2023-04-30 | $4,586,005 |
| Employer contributions (assets) at beginning of year | 2023-04-30 | $3,252,564 |
| Asset. Corporate debt instrument preferred debt at end of year | 2023-04-30 | $6,374,040 |
| Asset. Corporate debt instrument debt (other) at end of year | 2023-04-30 | $3,911,766 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2023-04-30 | $10,415,290 |
| Liabilities. Value of benefit claims payable at end of year | 2023-04-30 | $42,902,673 |
| Liabilities. Value of benefit claims payable at beginning of year | 2023-04-30 | $52,745,199 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2023-04-30 | $3,787,040 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2023-04-30 | $173,091 |
| Did the plan have assets held for investment | 2023-04-30 | 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 | 2023-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-04-30 | No |
| Aggregate proceeds on sale of assets | 2023-04-30 | $2,500,000 |
| Aggregate carrying amount (costs) on sale of assets | 2023-04-30 | $2,498,500 |
| Opinion of an independent qualified public accountant for this plan | 2023-04-30 | Unqualified |
| Accountancy firm name | 2023-04-30 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2023-04-30 | 611436956 |
| 2022 : UNITED WELFARE FUND-WELFARE DIVISION 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-04-30 | $-3,882,143 |
| Total unrealized appreciation/depreciation of assets | 2022-04-30 | $-3,882,143 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-04-30 | $55,655,267 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-04-30 | $45,179,600 |
| Total income from all sources (including contributions) | 2022-04-30 | $154,074,276 |
| Total of all expenses incurred | 2022-04-30 | $182,965,918 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-04-30 | $172,165,701 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-04-30 | $158,289,374 |
| Value of total assets at end of year | 2022-04-30 | $253,058,705 |
| Value of total assets at beginning of year | 2022-04-30 | $271,474,680 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-04-30 | $10,800,217 |
| Total interest from all sources | 2022-04-30 | $301,333 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-04-30 | $109,212 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-04-30 | $109,212 |
| Administrative expenses professional fees incurred | 2022-04-30 | $712,344 |
| Was this plan covered by a fidelity bond | 2022-04-30 | Yes |
| Value of fidelity bond cover | 2022-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-04-30 | No |
| Contributions received from participants | 2022-04-30 | $1,060,542 |
| Participant contributions at end of year | 2022-04-30 | $8,946 |
| Participant contributions at beginning of year | 2022-04-30 | $15,704 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-04-30 | $161,879,725 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-04-30 | $3,932,232 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-04-30 | $3,136,279 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-04-30 | $2,383,050 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-04-30 | $2,744,601 |
| Other income not declared elsewhere | 2022-04-30 | $1,048,055 |
| Administrative expenses (other) incurred | 2022-04-30 | $10,000,300 |
| Liabilities. Value of operating payables at end of year | 2022-04-30 | $527,018 |
| Liabilities. Value of operating payables at beginning of year | 2022-04-30 | $290,054 |
| Total non interest bearing cash at end of year | 2022-04-30 | $386,436 |
| Total non interest bearing cash at beginning of year | 2022-04-30 | $2,283,166 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-04-30 | No |
| Value of net income/loss | 2022-04-30 | $-28,891,642 |
| Value of net assets at end of year (total assets less liabilities) | 2022-04-30 | $197,403,438 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-04-30 | $226,295,080 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-04-30 | No |
| Investment advisory and management fees | 2022-04-30 | $87,573 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-04-30 | $189,522,222 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-04-30 | $259,683,638 |
| Income. Interest from US Government securities | 2022-04-30 | $199,455 |
| Income. Interest from corporate debt instruments | 2022-04-30 | $101,878 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-04-30 | $10,285,976 |
| Asset value of US Government securities at end of year | 2022-04-30 | $45,367,924 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-04-30 | $-1,791,555 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-04-30 | No |
| Contributions received in cash from employer | 2022-04-30 | $157,228,832 |
| Employer contributions (assets) at end of year | 2022-04-30 | $3,252,564 |
| Employer contributions (assets) at beginning of year | 2022-04-30 | $6,198,099 |
| Asset. Corporate debt instrument debt (other) at end of year | 2022-04-30 | $10,415,290 |
| Liabilities. Value of benefit claims payable at end of year | 2022-04-30 | $52,745,199 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-04-30 | $42,144,945 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2022-04-30 | $173,091 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2022-04-30 | $157,794 |
| Did the plan have assets held for investment | 2022-04-30 | 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 | 2022-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-04-30 | Unqualified |
| Accountancy firm name | 2022-04-30 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2022-04-30 | 611436956 |
| 2021 : UNITED WELFARE FUND-WELFARE DIVISION 2021 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-04-30 | $45,179,600 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-04-30 | $24,076,476 |
| Total income from all sources (including contributions) | 2021-04-30 | $168,851,158 |
| Total of all expenses incurred | 2021-04-30 | $155,968,585 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-04-30 | $145,264,360 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-04-30 | $168,789,191 |
| Value of total assets at end of year | 2021-04-30 | $271,474,680 |
| Value of total assets at beginning of year | 2021-04-30 | $237,488,983 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-04-30 | $10,704,225 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-04-30 | $43,098 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-04-30 | $43,098 |
| Administrative expenses professional fees incurred | 2021-04-30 | $668,691 |
| Was this plan covered by a fidelity bond | 2021-04-30 | Yes |
| Value of fidelity bond cover | 2021-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-04-30 | No |
| Contributions received from participants | 2021-04-30 | $1,443,297 |
| Participant contributions at end of year | 2021-04-30 | $15,704 |
| Participant contributions at beginning of year | 2021-04-30 | $22,996 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-04-30 | $136,612,583 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-04-30 | $3,136,279 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-04-30 | $3,061,408 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-04-30 | $2,744,601 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-04-30 | $1,075,830 |
| Other income not declared elsewhere | 2021-04-30 | $18,869 |
| Administrative expenses (other) incurred | 2021-04-30 | $9,983,534 |
| Liabilities. Value of operating payables at end of year | 2021-04-30 | $290,054 |
| Liabilities. Value of operating payables at beginning of year | 2021-04-30 | $181,647 |
| Total non interest bearing cash at end of year | 2021-04-30 | $2,283,166 |
| Total non interest bearing cash at beginning of year | 2021-04-30 | $848,561 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-04-30 | No |
| Value of net income/loss | 2021-04-30 | $12,882,573 |
| Value of net assets at end of year (total assets less liabilities) | 2021-04-30 | $226,295,080 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-04-30 | $213,412,507 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-04-30 | No |
| Investment advisory and management fees | 2021-04-30 | $52,000 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-04-30 | $259,683,638 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-04-30 | $229,650,721 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-04-30 | $8,651,777 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-04-30 | No |
| Contributions received in cash from employer | 2021-04-30 | $167,345,894 |
| Employer contributions (assets) at end of year | 2021-04-30 | $6,198,099 |
| Employer contributions (assets) at beginning of year | 2021-04-30 | $3,695,361 |
| Liabilities. Value of benefit claims payable at end of year | 2021-04-30 | $42,144,945 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-04-30 | $22,818,999 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2021-04-30 | $157,794 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2021-04-30 | $209,936 |
| Did the plan have assets held for investment | 2021-04-30 | 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 | 2021-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-04-30 | Unqualified |
| Accountancy firm name | 2021-04-30 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2021-04-30 | 611436956 |
| 2020 : UNITED WELFARE FUND-WELFARE DIVISION 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-04-30 | $24,076,476 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-04-30 | $27,105,669 |
| Total income from all sources (including contributions) | 2020-04-30 | $156,355,462 |
| Total of all expenses incurred | 2020-04-30 | $132,272,491 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-04-30 | $122,388,233 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-04-30 | $153,036,117 |
| Value of total assets at end of year | 2020-04-30 | $237,488,983 |
| Value of total assets at beginning of year | 2020-04-30 | $216,435,205 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-04-30 | $9,884,258 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-04-30 | $3,297,149 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-04-30 | $3,297,149 |
| Administrative expenses professional fees incurred | 2020-04-30 | $496,659 |
| Was this plan covered by a fidelity bond | 2020-04-30 | Yes |
| Value of fidelity bond cover | 2020-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-04-30 | No |
| Contributions received from participants | 2020-04-30 | $1,356,922 |
| Participant contributions at end of year | 2020-04-30 | $22,996 |
| Participant contributions at beginning of year | 2020-04-30 | $9,881 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-04-30 | $117,206,214 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-04-30 | $3,061,408 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-04-30 | $2,962,265 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-04-30 | $1,075,830 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-04-30 | $1,405,232 |
| Other income not declared elsewhere | 2020-04-30 | $22,196 |
| Administrative expenses (other) incurred | 2020-04-30 | $9,348,962 |
| Liabilities. Value of operating payables at end of year | 2020-04-30 | $181,647 |
| Liabilities. Value of operating payables at beginning of year | 2020-04-30 | $185,320 |
| Total non interest bearing cash at end of year | 2020-04-30 | $848,561 |
| Total non interest bearing cash at beginning of year | 2020-04-30 | $864,977 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-04-30 | No |
| Value of net income/loss | 2020-04-30 | $24,082,971 |
| Value of net assets at end of year (total assets less liabilities) | 2020-04-30 | $213,412,507 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-04-30 | $189,329,536 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-04-30 | No |
| Investment advisory and management fees | 2020-04-30 | $38,637 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-04-30 | $229,650,721 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-04-30 | $209,869,019 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-04-30 | $5,182,019 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-04-30 | No |
| Contributions received in cash from employer | 2020-04-30 | $151,679,195 |
| Employer contributions (assets) at end of year | 2020-04-30 | $3,695,361 |
| Employer contributions (assets) at beginning of year | 2020-04-30 | $2,485,082 |
| Liabilities. Value of benefit claims payable at end of year | 2020-04-30 | $22,818,999 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-04-30 | $25,515,117 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2020-04-30 | $209,936 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2020-04-30 | $243,981 |
| Did the plan have assets held for investment | 2020-04-30 | 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 | 2020-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-04-30 | Unqualified |
| Accountancy firm name | 2020-04-30 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2020-04-30 | 611436956 |
| 2019 : UNITED WELFARE FUND-WELFARE DIVISION 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-04-30 | $27,105,669 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-04-30 | $20,223,620 |
| Total income from all sources (including contributions) | 2019-04-30 | $164,759,450 |
| Total of all expenses incurred | 2019-04-30 | $150,808,292 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-04-30 | $141,097,323 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-04-30 | $160,987,412 |
| Value of total assets at end of year | 2019-04-30 | $216,435,205 |
| Value of total assets at beginning of year | 2019-04-30 | $195,601,998 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-04-30 | $9,710,969 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-04-30 | $3,750,624 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-04-30 | $3,750,624 |
| Administrative expenses professional fees incurred | 2019-04-30 | $860,190 |
| Was this plan covered by a fidelity bond | 2019-04-30 | Yes |
| Value of fidelity bond cover | 2019-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-04-30 | No |
| Contributions received from participants | 2019-04-30 | $1,380,830 |
| Participant contributions at end of year | 2019-04-30 | $9,881 |
| Participant contributions at beginning of year | 2019-04-30 | $7,865 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-04-30 | $135,892,662 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-04-30 | $2,962,265 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-04-30 | $2,203,762 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-04-30 | $1,405,232 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-04-30 | $1,514,334 |
| Other income not declared elsewhere | 2019-04-30 | $21,414 |
| Administrative expenses (other) incurred | 2019-04-30 | $8,849,460 |
| Liabilities. Value of operating payables at end of year | 2019-04-30 | $185,320 |
| Liabilities. Value of operating payables at beginning of year | 2019-04-30 | $170,627 |
| Total non interest bearing cash at end of year | 2019-04-30 | $864,977 |
| Total non interest bearing cash at beginning of year | 2019-04-30 | $2,208,397 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-04-30 | No |
| Value of net income/loss | 2019-04-30 | $13,951,158 |
| Value of net assets at end of year (total assets less liabilities) | 2019-04-30 | $189,329,536 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-04-30 | $175,378,378 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-04-30 | No |
| Investment advisory and management fees | 2019-04-30 | $1,319 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-04-30 | $209,869,019 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-04-30 | $188,193,242 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-04-30 | $5,204,661 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-04-30 | No |
| Contributions received in cash from employer | 2019-04-30 | $159,606,582 |
| Employer contributions (assets) at end of year | 2019-04-30 | $2,485,082 |
| Employer contributions (assets) at beginning of year | 2019-04-30 | $2,745,084 |
| Liabilities. Value of benefit claims payable at end of year | 2019-04-30 | $25,515,117 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-04-30 | $18,538,659 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2019-04-30 | $243,981 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2019-04-30 | $243,648 |
| Did the plan have assets held for investment | 2019-04-30 | 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 | 2019-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-04-30 | Unqualified |
| Accountancy firm name | 2019-04-30 | NOVAK FRANCELLA LLC |
| Accountancy firm EIN | 2019-04-30 | 611436956 |
| 2018 : UNITED WELFARE FUND-WELFARE DIVISION 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-04-30 | $20,223,620 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-04-30 | $18,824,865 |
| Total income from all sources (including contributions) | 2018-04-30 | $156,660,283 |
| Total of all expenses incurred | 2018-04-30 | $138,644,372 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-04-30 | $129,814,722 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-04-30 | $155,053,673 |
| Value of total assets at end of year | 2018-04-30 | $195,601,998 |
| Value of total assets at beginning of year | 2018-04-30 | $176,187,332 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-04-30 | $8,829,650 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-04-30 | $1,605,660 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-04-30 | $1,605,660 |
| Administrative expenses professional fees incurred | 2018-04-30 | $423,551 |
| Was this plan covered by a fidelity bond | 2018-04-30 | Yes |
| Value of fidelity bond cover | 2018-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-04-30 | No |
| Contributions received from participants | 2018-04-30 | $1,322,182 |
| Participant contributions at end of year | 2018-04-30 | $7,865 |
| Participant contributions at beginning of year | 2018-04-30 | $14,596 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-04-30 | $124,505,060 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-04-30 | $2,203,762 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-04-30 | $1,863,230 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-04-30 | $1,514,334 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-04-30 | $1,631,794 |
| Other income not declared elsewhere | 2018-04-30 | $950 |
| Administrative expenses (other) incurred | 2018-04-30 | $8,406,099 |
| Liabilities. Value of operating payables at end of year | 2018-04-30 | $170,627 |
| Liabilities. Value of operating payables at beginning of year | 2018-04-30 | $174,089 |
| Total non interest bearing cash at end of year | 2018-04-30 | $2,208,397 |
| Total non interest bearing cash at beginning of year | 2018-04-30 | $4,296,095 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-04-30 | No |
| Value of net income/loss | 2018-04-30 | $18,015,911 |
| Value of net assets at end of year (total assets less liabilities) | 2018-04-30 | $175,378,378 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-04-30 | $157,362,467 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-04-30 | $188,193,242 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-04-30 | $166,987,186 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-04-30 | $5,309,662 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-04-30 | No |
| Contributions received in cash from employer | 2018-04-30 | $153,731,491 |
| Employer contributions (assets) at end of year | 2018-04-30 | $2,745,084 |
| Employer contributions (assets) at beginning of year | 2018-04-30 | $2,736,871 |
| Liabilities. Value of benefit claims payable at end of year | 2018-04-30 | $18,538,659 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-04-30 | $17,018,982 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2018-04-30 | $243,648 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2018-04-30 | $289,354 |
| Did the plan have assets held for investment | 2018-04-30 | 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 | 2018-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-04-30 | Unqualified |
| Accountancy firm name | 2018-04-30 | NOVAK FRANCELLA LLC |
| Accountancy firm EIN | 2018-04-30 | 611436956 |
| 2017 : UNITED WELFARE FUND-WELFARE DIVISION 2017 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-04-30 | $18,824,865 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-04-30 | $16,666,820 |
| Total income from all sources (including contributions) | 2017-04-30 | $150,285,969 |
| Total of all expenses incurred | 2017-04-30 | $131,957,953 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-04-30 | $122,255,025 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-04-30 | $149,980,654 |
| Value of total assets at end of year | 2017-04-30 | $176,187,332 |
| Value of total assets at beginning of year | 2017-04-30 | $155,701,271 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-04-30 | $9,702,928 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-04-30 | $289,123 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-04-30 | $289,123 |
| Administrative expenses professional fees incurred | 2017-04-30 | $497,948 |
| Was this plan covered by a fidelity bond | 2017-04-30 | Yes |
| Value of fidelity bond cover | 2017-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-04-30 | No |
| Contributions received from participants | 2017-04-30 | $1,414,311 |
| Participant contributions at end of year | 2017-04-30 | $14,596 |
| Participant contributions at beginning of year | 2017-04-30 | $14,944 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-04-30 | $116,823,498 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-04-30 | $1,863,230 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-04-30 | $868,639 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-04-30 | $1,631,794 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-04-30 | $1,425,144 |
| Other income not declared elsewhere | 2017-04-30 | $16,192 |
| Administrative expenses (other) incurred | 2017-04-30 | $9,204,980 |
| Liabilities. Value of operating payables at end of year | 2017-04-30 | $174,089 |
| Liabilities. Value of operating payables at beginning of year | 2017-04-30 | $180,293 |
| Total non interest bearing cash at end of year | 2017-04-30 | $4,296,095 |
| Total non interest bearing cash at beginning of year | 2017-04-30 | $3,004,250 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-04-30 | No |
| Value of net income/loss | 2017-04-30 | $18,328,016 |
| Value of net assets at end of year (total assets less liabilities) | 2017-04-30 | $157,362,467 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-04-30 | $139,034,451 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-04-30 | $166,987,186 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-04-30 | $149,391,976 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-04-30 | $5,431,527 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-04-30 | No |
| Contributions received in cash from employer | 2017-04-30 | $148,566,343 |
| Employer contributions (assets) at end of year | 2017-04-30 | $2,736,871 |
| Employer contributions (assets) at beginning of year | 2017-04-30 | $2,252,270 |
| Liabilities. Value of benefit claims payable at end of year | 2017-04-30 | $17,018,982 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-04-30 | $15,061,383 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2017-04-30 | $289,354 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2017-04-30 | $169,192 |
| Did the plan have assets held for investment | 2017-04-30 | 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 | 2017-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-04-30 | Unqualified |
| Accountancy firm name | 2017-04-30 | NOVAK FRANCELLA LLC |
| Accountancy firm EIN | 2017-04-30 | 611436956 |
| 2016 : UNITED WELFARE FUND-WELFARE DIVISION 2016 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-04-30 | $16,666,820 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-04-30 | $14,580,850 |
| Total income from all sources (including contributions) | 2016-04-30 | $144,703,918 |
| Total of all expenses incurred | 2016-04-30 | $134,702,335 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-04-30 | $124,478,269 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-04-30 | $144,688,592 |
| Value of total assets at end of year | 2016-04-30 | $155,701,271 |
| Value of total assets at beginning of year | 2016-04-30 | $143,613,718 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-04-30 | $10,224,066 |
| Total interest from all sources | 2016-04-30 | $14,137 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-04-30 | No |
| Administrative expenses professional fees incurred | 2016-04-30 | $541,023 |
| Was this plan covered by a fidelity bond | 2016-04-30 | Yes |
| Value of fidelity bond cover | 2016-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-04-30 | No |
| Contributions received from participants | 2016-04-30 | $1,243,106 |
| Participant contributions at end of year | 2016-04-30 | $14,944 |
| Participant contributions at beginning of year | 2016-04-30 | $8,400 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-04-30 | $119,316,088 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-04-30 | $868,639 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-04-30 | $879,922 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-04-30 | $1,425,144 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-04-30 | $1,391,139 |
| Other income not declared elsewhere | 2016-04-30 | $1,189 |
| Administrative expenses (other) incurred | 2016-04-30 | $9,353,043 |
| Liabilities. Value of operating payables at end of year | 2016-04-30 | $180,293 |
| Liabilities. Value of operating payables at beginning of year | 2016-04-30 | $207,720 |
| Total non interest bearing cash at end of year | 2016-04-30 | $3,004,250 |
| Total non interest bearing cash at beginning of year | 2016-04-30 | $3,665,064 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-04-30 | No |
| Value of net income/loss | 2016-04-30 | $10,001,583 |
| Value of net assets at end of year (total assets less liabilities) | 2016-04-30 | $139,034,451 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-04-30 | $129,032,868 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-04-30 | $149,391,976 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-04-30 | $136,729,003 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-04-30 | $14,137 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-04-30 | $5,162,181 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-04-30 | No |
| Contributions received in cash from employer | 2016-04-30 | $143,445,486 |
| Employer contributions (assets) at end of year | 2016-04-30 | $2,252,270 |
| Employer contributions (assets) at beginning of year | 2016-04-30 | $2,099,967 |
| Contract administrator fees | 2016-04-30 | $330,000 |
| Liabilities. Value of benefit claims payable at end of year | 2016-04-30 | $15,061,383 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-04-30 | $12,981,991 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2016-04-30 | $169,192 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2016-04-30 | $231,362 |
| Did the plan have assets held for investment | 2016-04-30 | 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 | 2016-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-04-30 | Unqualified |
| Accountancy firm name | 2016-04-30 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2016-04-30 | 611436956 |
| 2015 : UNITED WELFARE FUND-WELFARE DIVISION 2015 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-04-30 | $14,580,850 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-04-30 | $8,825,957 |
| Total income from all sources (including contributions) | 2015-04-30 | $146,526,244 |
| Total of all expenses incurred | 2015-04-30 | $122,939,450 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-04-30 | $114,148,287 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-04-30 | $146,519,027 |
| Value of total assets at end of year | 2015-04-30 | $143,613,718 |
| Value of total assets at beginning of year | 2015-04-30 | $114,272,031 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-04-30 | $8,791,163 |
| Total interest from all sources | 2015-04-30 | $7,217 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-04-30 | No |
| Administrative expenses professional fees incurred | 2015-04-30 | $644,271 |
| Was this plan covered by a fidelity bond | 2015-04-30 | Yes |
| Value of fidelity bond cover | 2015-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-04-30 | No |
| Contributions received from participants | 2015-04-30 | $1,458,793 |
| Participant contributions at end of year | 2015-04-30 | $8,400 |
| Participant contributions at beginning of year | 2015-04-30 | $51,500 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2015-04-30 | $108,391,302 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-04-30 | $879,922 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-04-30 | $54,748 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-04-30 | $1,391,139 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-04-30 | $1,161,503 |
| Administrative expenses (other) incurred | 2015-04-30 | $8,146,892 |
| Liabilities. Value of operating payables at end of year | 2015-04-30 | $207,720 |
| Liabilities. Value of operating payables at beginning of year | 2015-04-30 | $81,454 |
| Total non interest bearing cash at end of year | 2015-04-30 | $3,665,064 |
| Total non interest bearing cash at beginning of year | 2015-04-30 | $3,871,535 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-04-30 | No |
| Value of net income/loss | 2015-04-30 | $23,586,794 |
| Value of net assets at end of year (total assets less liabilities) | 2015-04-30 | $129,032,868 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-04-30 | $105,446,074 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-04-30 | $136,729,003 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-04-30 | $108,387,419 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-04-30 | $7,217 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-04-30 | $5,756,410 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-04-30 | No |
| Contributions received in cash from employer | 2015-04-30 | $145,060,234 |
| Employer contributions (assets) at end of year | 2015-04-30 | $2,099,967 |
| Employer contributions (assets) at beginning of year | 2015-04-30 | $1,640,534 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-04-30 | $575 |
| Liabilities. Value of benefit claims payable at end of year | 2015-04-30 | $12,981,991 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-04-30 | $7,583,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2015-04-30 | $231,362 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2015-04-30 | $266,295 |
| Did the plan have assets held for investment | 2015-04-30 | 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 | 2015-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-04-30 | Unqualified |
| Accountancy firm name | 2015-04-30 | SAXBST LLP |
| Accountancy firm EIN | 2015-04-30 | 464001827 |
| 2014 : UNITED WELFARE FUND-WELFARE DIVISION 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-04-30 | $8,825,957 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-04-30 | $1,258,553 |
| Total income from all sources (including contributions) | 2014-04-30 | $135,174,467 |
| Total of all expenses incurred | 2014-04-30 | $127,827,649 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-04-30 | $119,641,141 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-04-30 | $135,170,165 |
| Value of total assets at end of year | 2014-04-30 | $114,272,031 |
| Value of total assets at beginning of year | 2014-04-30 | $99,357,809 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-04-30 | $8,186,508 |
| Total interest from all sources | 2014-04-30 | $30 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-04-30 | No |
| Administrative expenses professional fees incurred | 2014-04-30 | $558,609 |
| Was this plan covered by a fidelity bond | 2014-04-30 | Yes |
| Value of fidelity bond cover | 2014-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2014-04-30 | No |
| Contributions received from participants | 2014-04-30 | $3,915,213 |
| Participant contributions at end of year | 2014-04-30 | $51,500 |
| Participant contributions at beginning of year | 2014-04-30 | $21,000 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-04-30 | $24,189,718 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-04-30 | $54,748 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-04-30 | $668,034 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-04-30 | $1,161,503 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-04-30 | $318,826 |
| Other income not declared elsewhere | 2014-04-30 | $4,272 |
| Administrative expenses (other) incurred | 2014-04-30 | $7,627,899 |
| Liabilities. Value of operating payables at end of year | 2014-04-30 | $81,454 |
| Liabilities. Value of operating payables at beginning of year | 2014-04-30 | $236,499 |
| Total non interest bearing cash at end of year | 2014-04-30 | $3,871,535 |
| Total non interest bearing cash at beginning of year | 2014-04-30 | $1,655,313 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-04-30 | No |
| Value of net income/loss | 2014-04-30 | $7,346,818 |
| Value of net assets at end of year (total assets less liabilities) | 2014-04-30 | $105,446,074 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-04-30 | $98,099,256 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-04-30 | $108,387,419 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-04-30 | $93,793,668 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-04-30 | $30 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-04-30 | $95,451,012 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-04-30 | No |
| Contributions received in cash from employer | 2014-04-30 | $131,254,952 |
| Employer contributions (assets) at end of year | 2014-04-30 | $1,640,534 |
| Employer contributions (assets) at beginning of year | 2014-04-30 | $2,975,342 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-04-30 | $411 |
| Liabilities. Value of benefit claims payable at end of year | 2014-04-30 | $7,583,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-04-30 | $703,228 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2014-04-30 | $266,295 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2014-04-30 | $244,452 |
| Did the plan have assets held for investment | 2014-04-30 | 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 | 2014-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-04-30 | Unqualified |
| Accountancy firm name | 2014-04-30 | SAXBST LLP |
| Accountancy firm EIN | 2014-04-30 | 464001827 |
| 2013 : UNITED WELFARE FUND-WELFARE DIVISION 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-04-30 | $1,258,553 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-04-30 | $1,605,253 |
| Total income from all sources (including contributions) | 2013-04-30 | $138,179,053 |
| Total of all expenses incurred | 2013-04-30 | $127,765,781 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-04-30 | $119,355,393 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-04-30 | $138,173,882 |
| Value of total assets at end of year | 2013-04-30 | $99,357,809 |
| Value of total assets at beginning of year | 2013-04-30 | $89,291,237 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-04-30 | $8,410,388 |
| Total interest from all sources | 2013-04-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-04-30 | No |
| Administrative expenses professional fees incurred | 2013-04-30 | $464,828 |
| Was this plan covered by a fidelity bond | 2013-04-30 | Yes |
| Value of fidelity bond cover | 2013-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2013-04-30 | No |
| Contributions received from participants | 2013-04-30 | $5,285,273 |
| Participant contributions at end of year | 2013-04-30 | $21,000 |
| Participant contributions at beginning of year | 2013-04-30 | $15,000 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-04-30 | $2,538,368 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-04-30 | $668,034 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-04-30 | $204,974 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-04-30 | $318,826 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-04-30 | $1,198,474 |
| Other income not declared elsewhere | 2013-04-30 | $5,171 |
| Administrative expenses (other) incurred | 2013-04-30 | $7,945,560 |
| Liabilities. Value of operating payables at end of year | 2013-04-30 | $236,499 |
| Liabilities. Value of operating payables at beginning of year | 2013-04-30 | $406,779 |
| Total non interest bearing cash at end of year | 2013-04-30 | $1,655,313 |
| Total non interest bearing cash at beginning of year | 2013-04-30 | $2,295,264 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-04-30 | No |
| Value of net income/loss | 2013-04-30 | $10,413,272 |
| Value of net assets at end of year (total assets less liabilities) | 2013-04-30 | $98,099,256 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-04-30 | $87,685,984 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-04-30 | $93,793,668 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-04-30 | $84,285,046 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-04-30 | $116,816,358 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-04-30 | No |
| Contributions received in cash from employer | 2013-04-30 | $132,888,609 |
| Employer contributions (assets) at end of year | 2013-04-30 | $2,975,342 |
| Employer contributions (assets) at beginning of year | 2013-04-30 | $2,316,936 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-04-30 | $667 |
| Liabilities. Value of benefit claims payable at end of year | 2013-04-30 | $703,228 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2013-04-30 | $244,452 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2013-04-30 | $174,017 |
| Did the plan have assets held for investment | 2013-04-30 | 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 | 2013-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-04-30 | Unqualified |
| Accountancy firm name | 2013-04-30 | SAXBST LLP |
| Accountancy firm EIN | 2013-04-30 | 464001827 |
| 2012 : UNITED WELFARE FUND-WELFARE DIVISION 2012 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-04-30 | $1,605,253 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-04-30 | $2,819,294 |
| Total income from all sources (including contributions) | 2012-04-30 | $135,113,597 |
| Total of all expenses incurred | 2012-04-30 | $130,128,711 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-04-30 | $121,984,128 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-04-30 | $135,107,160 |
| Value of total assets at end of year | 2012-04-30 | $89,291,237 |
| Value of total assets at beginning of year | 2012-04-30 | $85,520,392 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-04-30 | $8,144,583 |
| Total interest from all sources | 2012-04-30 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-04-30 | $886 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-04-30 | $886 |
| Administrative expenses professional fees incurred | 2012-04-30 | $400,941 |
| Was this plan covered by a fidelity bond | 2012-04-30 | Yes |
| Value of fidelity bond cover | 2012-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-04-30 | No |
| Contributions received from participants | 2012-04-30 | $6,616,521 |
| Participant contributions at end of year | 2012-04-30 | $15,000 |
| Participant contributions at beginning of year | 2012-04-30 | $16,000 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-04-30 | $994,264 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-04-30 | $204,974 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-04-30 | $229,202 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-04-30 | $1,198,474 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-04-30 | $1,593,346 |
| Other income not declared elsewhere | 2012-04-30 | $5,551 |
| Administrative expenses (other) incurred | 2012-04-30 | $7,743,642 |
| Liabilities. Value of operating payables at end of year | 2012-04-30 | $406,779 |
| Liabilities. Value of operating payables at beginning of year | 2012-04-30 | $604,948 |
| Total non interest bearing cash at end of year | 2012-04-30 | $2,295,264 |
| Total non interest bearing cash at beginning of year | 2012-04-30 | $2,267,987 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-04-30 | No |
| Value of net income/loss | 2012-04-30 | $4,984,886 |
| Value of net assets at end of year (total assets less liabilities) | 2012-04-30 | $87,685,984 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-04-30 | $82,701,098 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-04-30 | $84,285,046 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-04-30 | $80,175,734 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-04-30 | $80,175,734 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-04-30 | $121,018,396 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-04-30 | No |
| Contributions received in cash from employer | 2012-04-30 | $127,496,375 |
| Employer contributions (assets) at end of year | 2012-04-30 | $2,316,936 |
| Employer contributions (assets) at beginning of year | 2012-04-30 | $2,741,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-04-30 | $965,732 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-04-30 | $621,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2012-04-30 | $174,017 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-04-30 | $90,469 |
| Did the plan have assets held for investment | 2012-04-30 | 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 | 2012-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-04-30 | Unqualified |
| Accountancy firm name | 2012-04-30 | BOLLAM SHEEDY TORANI & CO LLP CPA |
| Accountancy firm EIN | 2012-04-30 | 141442607 |
| 2011 : UNITED WELFARE FUND-WELFARE DIVISION 2011 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2011-04-30 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-04-30 | $2,819,294 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-04-30 | $2,805,780 |
| Total income from all sources (including contributions) | 2011-04-30 | $136,766,759 |
| Total loss/gain on sale of assets | 2011-04-30 | $0 |
| Total of all expenses incurred | 2011-04-30 | $132,489,140 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-04-30 | $124,624,718 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-04-30 | $136,756,455 |
| Value of total assets at end of year | 2011-04-30 | $85,520,392 |
| Value of total assets at beginning of year | 2011-04-30 | $81,229,259 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-04-30 | $7,864,422 |
| Total interest from all sources | 2011-04-30 | $10,304 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-04-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-04-30 | No |
| Administrative expenses professional fees incurred | 2011-04-30 | $712,775 |
| Was this plan covered by a fidelity bond | 2011-04-30 | Yes |
| Value of fidelity bond cover | 2011-04-30 | $2,500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-04-30 | No |
| Contributions received from participants | 2011-04-30 | $8,041,095 |
| Participant contributions at end of year | 2011-04-30 | $16,000 |
| Participant contributions at beginning of year | 2011-04-30 | $28,000 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2011-04-30 | $1,506,639 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-04-30 | $229,202 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-04-30 | $676,799 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-04-30 | $1,593,346 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-04-30 | $2,006,065 |
| Administrative expenses (other) incurred | 2011-04-30 | $7,151,647 |
| Liabilities. Value of operating payables at end of year | 2011-04-30 | $604,948 |
| Liabilities. Value of operating payables at beginning of year | 2011-04-30 | $162,615 |
| Total non interest bearing cash at end of year | 2011-04-30 | $2,267,987 |
| Total non interest bearing cash at beginning of year | 2011-04-30 | $1,070,417 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-04-30 | No |
| Value of net income/loss | 2011-04-30 | $4,277,619 |
| Value of net assets at end of year (total assets less liabilities) | 2011-04-30 | $82,701,098 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-04-30 | $78,423,479 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-04-30 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-04-30 | $80,175,734 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-04-30 | $76,583,170 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-04-30 | $76,583,170 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-04-30 | $10,304 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-04-30 | $121,417,438 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-04-30 | No |
| Contributions received in cash from employer | 2011-04-30 | $127,208,721 |
| Employer contributions (assets) at end of year | 2011-04-30 | $2,741,000 |
| Employer contributions (assets) at beginning of year | 2011-04-30 | $2,800,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-04-30 | $3,207,280 |
| Liabilities. Value of benefit claims payable at end of year | 2011-04-30 | $621,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-04-30 | $637,100 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2011-04-30 | $90,469 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-04-30 | $70,873 |
| Did the plan have assets held for investment | 2011-04-30 | 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 | 2011-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-04-30 | Unqualified |
| Accountancy firm name | 2011-04-30 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2011-04-30 | 131577780 |
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213Y |
| Policy instance | 2 |
| Insurance contract or identification number | L1AK00213Y | | Number of Individuals Covered | 5699 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $296,939 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,726,474 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $161,967 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L0AJ00238Y |
| Policy instance | 1 |
| Insurance contract or identification number | L0AJ00238Y | | Number of Individuals Covered | 96 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $6,787 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,420 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,170 | | Insurance broker organization code? | 3 |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | USU834/USX834 |
| Policy instance | 11 |
| Insurance contract or identification number | USU834/USX834 | | Number of Individuals Covered | 15539 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $258,462 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L2AJ00214Y |
| Policy instance | 3 |
| Insurance contract or identification number | L2AJ00214Y | | Number of Individuals Covered | 175 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $8,061 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $79,358 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,328 | | Insurance broker organization code? | 3 |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 4 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 208 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $90,082 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216772 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 1101 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $594,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L4AK00413Y |
| Policy instance | 6 |
| Insurance contract or identification number | L4AK00413Y | | Number of Individuals Covered | 79 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2022-11-30 | | Total amount of commissions paid to insurance broker | USD $1,554 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,103 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,413 | | Insurance broker organization code? | 3 |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-726 |
| Policy instance | 7 |
| Insurance contract or identification number | GG-726 | | Number of Individuals Covered | 2991 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $18,122 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $234,430 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,122 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0231537 |
| Policy instance | 8 |
| Insurance contract or identification number | 0231537 | | Number of Individuals Covered | 64142 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $37,380 | | Total amount of fees paid to insurance company | USD $3,249 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $633,797 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,380 | | Amount paid for insurance broker fees | 3249 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 9 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 9148 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | 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 $571,987 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUPREME BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00000 |
| Policy instance | 10 |
| Insurance contract or identification number | 00000 | | Number of Individuals Covered | 8310 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $3,826,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216772 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 857 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $453,824 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L2AJ00214Y |
| Policy instance | 3 |
| Insurance contract or identification number | L2AJ00214Y | | Number of Individuals Covered | 183 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $7,133 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $65,927 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,485 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213Y |
| Policy instance | 2 |
| Insurance contract or identification number | L1AK00213Y | | Number of Individuals Covered | 4966 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $261,304 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,586,526 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $142,529 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L0AJ00238Y |
| Policy instance | 1 |
| Insurance contract or identification number | L0AJ00238Y | | Number of Individuals Covered | 108 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $6,982 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $61,096 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,347 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L4AK00413Y |
| Policy instance | 6 |
| Insurance contract or identification number | L4AK00413Y | | Number of Individuals Covered | 80 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Total amount of commissions paid to insurance broker | USD $1,577 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,381 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,434 | | Insurance broker organization code? | 3 |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-726 |
| Policy instance | 7 |
| Insurance contract or identification number | GG-726 | | Number of Individuals Covered | 1220 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $13,311 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $195,969 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,311 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0231537 |
| Policy instance | 8 |
| Insurance contract or identification number | 0231537 | | Number of Individuals Covered | 66532 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $37,565 | | 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 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $674,718 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,565 | | Insurance broker organization code? | 3 |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 4 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 223 | | Insurance policy start date | 2020-11-01 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,342 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 10112100 |
| Policy instance | 9 |
| Insurance contract or identification number | 10112100 | | Number of Individuals Covered | 8541 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $241,729 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 10 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 8570 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | 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 $546,544 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUPREME BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00000 |
| Policy instance | 11 |
| Insurance contract or identification number | 00000 | | Number of Individuals Covered | 7148 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $5,321,625 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 155084 |
| Policy instance | 6 |
| Insurance contract or identification number | GL 155084 | | Number of Individuals Covered | 5444 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $878 | | Total amount of fees paid to insurance company | USD $1,474 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $131,085 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1474 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES. | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $878 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216772 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 674 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $353,621 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 4 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 208 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $96,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L2AJ00214N/Y |
| Policy instance | 3 |
| Insurance contract or identification number | L2AJ00214N/Y | | Number of Individuals Covered | 194 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $8,160 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $68,349 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,160 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213N/Y |
| Policy instance | 2 |
| Insurance contract or identification number | L1AK00213N/Y | | Number of Individuals Covered | 5046 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $321,524 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,146,714 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $321,524 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L0AJ00238N/Y |
| Policy instance | 1 |
| Insurance contract or identification number | L0AJ00238N/Y | | Number of Individuals Covered | 122 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $14,543 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $106,158 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,543 | | Insurance broker organization code? | 3 |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206829 |
| Policy instance | 7 |
| Insurance contract or identification number | VAR 206829 | | Number of Individuals Covered | 5444 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,561 | | Total amount of fees paid to insurance company | USD $176 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $15,605 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,561 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 176 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206830 |
| Policy instance | 8 |
| Insurance contract or identification number | VAR 206830 | | Number of Individuals Covered | 54305 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $5,431 | | Total amount of fees paid to insurance company | USD $1,050 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $108,610 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,431 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1050 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES. |
|
| SUPREME BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00000 |
| Policy instance | 14 |
| Insurance contract or identification number | 00000 | | Number of Individuals Covered | 11386 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $3,883,386 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-726 |
| Policy instance | 13 |
| Insurance contract or identification number | GG-726 | | Number of Individuals Covered | 4048 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $18,775 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $267,051 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,775 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L4AK00413N/Y |
| Policy instance | 12 |
| Insurance contract or identification number | L4AK00413N/Y | | Number of Individuals Covered | 100 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Total amount of commissions paid to insurance broker | USD $1,900 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,900 | | Insurance broker organization code? | 3 |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | NIS1214 01 |
| Policy instance | 11 |
| Insurance contract or identification number | NIS1214 01 | | Number of Individuals Covered | 8438 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $545,905 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | G 164504 |
| Policy instance | 10 |
| Insurance contract or identification number | G 164504 | | Number of Individuals Covered | 2385 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $940 | | Total amount of fees paid to insurance company | USD $1,247 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $71,585 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1247 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $940 |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 9 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 8622 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | 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 $560,231 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L0AJ00238N |
| Policy instance | 1 |
| Insurance contract or identification number | L0AJ00238N | | Number of Individuals Covered | 243 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $17,093 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $153,892 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,093 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L2AJ00214N |
| Policy instance | 3 |
| Insurance contract or identification number | L2AJ00214N | | Number of Individuals Covered | 191 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $7,587 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $68,731 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,587 | | Insurance broker organization code? | 3 |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 4 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 268 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $107,636 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216772 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 609 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $331,923 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 155084 |
| Policy instance | 6 |
| Insurance contract or identification number | GL 155084 | | Number of Individuals Covered | 5390 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $3,861 | | Total amount of fees paid to insurance company | USD $1,605 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $161,798 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,861 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1605 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES. |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206829 |
| Policy instance | 7 |
| Insurance contract or identification number | VAR 206829 | | Number of Individuals Covered | 5390 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $1,926 | | Total amount of fees paid to insurance company | USD $191 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $19,262 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,926 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 191 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES. |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206830 |
| Policy instance | 8 |
| Insurance contract or identification number | VAR 206830 | | Number of Individuals Covered | 52501 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $5,250 | | Total amount of fees paid to insurance company | USD $910 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $105,002 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,250 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 910 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES. |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 9 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 8902 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | 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 $621,938 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | G 164504 |
| Policy instance | 10 |
| Insurance contract or identification number | G 164504 | | Number of Individuals Covered | 2566 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $4,454 | | Total amount of fees paid to insurance company | USD $1,375 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $133,910 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,454 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1375 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | NIS1214 01 |
| Policy instance | 11 |
| Insurance contract or identification number | NIS1214 01 | | Number of Individuals Covered | 9557 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $602,099 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L4AK00413N |
| Policy instance | 12 |
| Insurance contract or identification number | L4AK00413N | | Number of Individuals Covered | 79 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Total amount of commissions paid to insurance broker | USD $1,237 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,244 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,237 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213N |
| Policy instance | 2 |
| Insurance contract or identification number | L1AK00213N | | Number of Individuals Covered | 5514 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $316,279 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,636,972 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $316,279 | | Insurance broker organization code? | 3 |
|
| ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 ) |
| Policy contract number | 75570 |
| Policy instance | 6 |
| Insurance contract or identification number | 75570 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,670 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216772 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 611 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $303,551 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 4 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 264 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $111,756 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L2AJ00214N |
| Policy instance | 3 |
| Insurance contract or identification number | L2AJ00214N | | Number of Individuals Covered | 171 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $7,370 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,985 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,370 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213N |
| Policy instance | 2 |
| Insurance contract or identification number | L1AK00213N | | Number of Individuals Covered | 5475 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $312,805 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,839,504 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $312,805 | | Insurance broker organization code? | 3 |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L0AJ00238N |
| Policy instance | 1 |
| Insurance contract or identification number | L0AJ00238N | | Number of Individuals Covered | 278 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $19,386 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $173,758 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,386 | | Insurance broker organization code? | 3 |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206829 |
| Policy instance | 8 |
| Insurance contract or identification number | VAR 206829 | | Number of Individuals Covered | 5504 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $2,077 | | Total amount of fees paid to insurance company | USD $196 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $20,774 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,077 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 196 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 155084 |
| Policy instance | 7 |
| Insurance contract or identification number | GL 155084 | | Number of Individuals Covered | 5504 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $4,261 | | Total amount of fees paid to insurance company | USD $1,646 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $174,504 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,261 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1646 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | NIS1214 01 |
| Policy instance | 14 |
| Insurance contract or identification number | NIS1214 01 | | Number of Individuals Covered | 9557 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $501,242 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 ) |
| Policy contract number | 03633 |
| Policy instance | 13 |
| Insurance contract or identification number | 03633 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | G 164504 |
| Policy instance | 12 |
| Insurance contract or identification number | G 164504 | | Number of Individuals Covered | 2774 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $5,114 | | Total amount of fees paid to insurance company | USD $1,387 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $148,279 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,114 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1387 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| PARTNERRE AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11835 ) |
| Policy contract number | P03127540 03/04 |
| Policy instance | 11 |
| Insurance contract or identification number | P03127540 03/04 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $4,369 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $109,226 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,369 | | Insurance broker organization code? | 3 |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 10 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 10035 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | 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 $681,402 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206830 |
| Policy instance | 9 |
| Insurance contract or identification number | VAR 206830 | | Number of Individuals Covered | 45513 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $4,551 | | Total amount of fees paid to insurance company | USD $951 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $91,026 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,551 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 951 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 ) |
| Policy contract number | 75570 |
| Policy instance | 7 |
| Insurance contract or identification number | 75570 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,093 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0475069 |
| Policy instance | 6 |
| Insurance contract or identification number | 0475069 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,221 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216772 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 401 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $283,785 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 4 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 317 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $143,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L2AJ00214N |
| Policy instance | 3 |
| Insurance contract or identification number | L2AJ00214N | | Number of Individuals Covered | 165 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $1,482 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,215 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L0AJ00238N |
| Policy instance | 1 |
| Insurance contract or identification number | L0AJ00238N | | Number of Individuals Covered | 316 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $21,525 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $211,577 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213N |
| Policy instance | 2 |
| Insurance contract or identification number | L1AK00213N | | Number of Individuals Covered | 5472 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $295,770 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,874,627 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 155084 |
| Policy instance | 8 |
| Insurance contract or identification number | GL 155084 | | Number of Individuals Covered | 5606 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $3,449 | | Total amount of fees paid to insurance company | USD $7,399 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $149,064 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206829 |
| Policy instance | 9 |
| Insurance contract or identification number | VAR 206829 | | Number of Individuals Covered | 5606 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $1,775 | | Total amount of fees paid to insurance company | USD $881 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $17,746 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206830 |
| Policy instance | 10 |
| Insurance contract or identification number | VAR 206830 | | Number of Individuals Covered | 38048 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $3,881 | | Total amount of fees paid to insurance company | USD $3,092 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $77,620 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PARTNERRE AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11835 ) |
| Policy contract number | P03127540 03/04 |
| Policy instance | 12 |
| Insurance contract or identification number | P03127540 03/04 | | Number of Individuals Covered | 10289 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $26,369 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $645,837 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 11 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 10794 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | 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 $689,235 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US013941 |
| Policy instance | 13 |
| Insurance contract or identification number | US013941 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $183 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $2,122 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | G 164504 |
| Policy instance | 14 |
| Insurance contract or identification number | G 164504 | | Number of Individuals Covered | 2735 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $4,053 | | Total amount of fees paid to insurance company | USD $5,836 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $128,063 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 ) |
| Policy contract number | 03633 |
| Policy instance | 15 |
| Insurance contract or identification number | 03633 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0713160 |
| Policy instance | 16 |
| Insurance contract or identification number | 0713160 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2016-12-31 | | 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 $30,030 | | 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 | 0713160 |
| Policy instance | 19 |
| Insurance contract or identification number | 0713160 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | 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 $45,367 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L2AJ00214N |
| Policy instance | 3 |
| Insurance contract or identification number | L2AJ00214N | | Number of Individuals Covered | 188 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $6,304 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,303 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,304 | | Insurance broker organization code? | 3 | | Insurance broker name | KRITZER CONSULTING SERVICES |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206830 |
| Policy instance | 15 |
| Insurance contract or identification number | VAR 206830 | | Number of Individuals Covered | 32638 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $816 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $16,319 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $816 | | Insurance broker organization code? | 3 | | Insurance broker name | LIGHTHOUSE PLANNING GROUP |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213N |
| Policy instance | 2 |
| Insurance contract or identification number | L1AK00213N | | Number of Individuals Covered | 5642 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $319,549 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,701,918 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $319,549 | | Insurance broker organization code? | 3 | | Insurance broker name | KRITZER CONSULTING SERVICES |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 16 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 10130 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | 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 $492,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PARTNERRE AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11835 ) |
| Policy contract number | P0312754002 |
| Policy instance | 17 |
| Insurance contract or identification number | P0312754002 | | Number of Individuals Covered | 9588 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $587,032 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US013941 |
| Policy instance | 18 |
| Insurance contract or identification number | US013941 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $314 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $4,971 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $314 | | Insurance broker organization code? | 3 | | Insurance broker name | CENTERSTONE INSURANCE AND FIN SVCS |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | G 164504 |
| Policy instance | 20 |
| Insurance contract or identification number | G 164504 | | Number of Individuals Covered | 2799 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $2,868 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,369 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,868 | | Insurance broker organization code? | 3 | | Insurance broker name | LIGHTHOUSE PLANNING GROUP |
|
| NORTH SHORE LIJ CARECONNECT HEALTH INSURANCE INC. (National Association of Insurance Commissioners NAIC id number: 15309 ) |
| Policy contract number | L00173/00174 |
| Policy instance | 21 |
| Insurance contract or identification number | L00173/00174 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $264 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,589 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $264 | | Insurance broker organization code? | 3 | | Insurance broker name | OMNI MANAGED HEALTH - B. WEISSMAN |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L0AJ00238N |
| Policy instance | 1 |
| Insurance contract or identification number | L0AJ00238N | | Number of Individuals Covered | 441 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $28,896 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $262,624 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,896 | | Insurance broker organization code? | 3 | | Insurance broker name | KRITZER CONSULTING SERVICES |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | VAR 206829 |
| Policy instance | 14 |
| Insurance contract or identification number | VAR 206829 | | Number of Individuals Covered | 5494 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $485 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $4,852 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $485 | | Insurance broker organization code? | 3 | | Insurance broker name | LIGHTHOUSE PLANNING GROUP |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 155084 |
| Policy instance | 13 |
| Insurance contract or identification number | GL 155084 | | Number of Individuals Covered | 5494 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $2,680 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,754 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,680 | | Insurance broker organization code? | 3 | | Insurance broker name | LIGHTHOUSE PLANNING GROUP |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | ADDS05438 |
| Policy instance | 12 |
| Insurance contract or identification number | ADDS05438 | | Number of Individuals Covered | 32638 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $13,058 | | Total amount of fees paid to insurance company | USD $389 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $65,291 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,058 | | Amount paid for insurance broker fees | 389 | | Additional information about fees paid to insurance broker | BONUS PAID | | Insurance broker organization code? | 3 | | Insurance broker name | WINSTON FINANCIAL SERVICES |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 4 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 320 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $121,103 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216772 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 344 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $216,850 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0475069 |
| Policy instance | 6 |
| Insurance contract or identification number | 0475069 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,534 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 ) |
| Policy contract number | 03633 |
| Policy instance | 7 |
| Insurance contract or identification number | 03633 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 10306 |
| Policy instance | 8 |
| Insurance contract or identification number | 10306 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,292 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 ) |
| Policy contract number | 75570 |
| Policy instance | 9 |
| Insurance contract or identification number | 75570 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,557 | | 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 | 033725G |
| Policy instance | 10 |
| Insurance contract or identification number | 033725G | | Number of Individuals Covered | 2705 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $5,008 | | Total amount of fees paid to insurance company | USD $6,753 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $139,219 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 6753 | | Additional information about fees paid to insurance broker | AGENT/BROKER FEES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $4,886 | | Insurance broker name | LIGHTHOUSE PLANNING GROUP |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 402613G |
| Policy instance | 11 |
| Insurance contract or identification number | 402613G | | Number of Individuals Covered | 5372 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $9,803 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $179,841 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,197 | | Insurance broker organization code? | 3 | | Insurance broker name | LIGHTHOUSE PLANNING GROUP |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GRH-033725G |
| Policy instance | 10 |
| Insurance contract or identification number | GRH-033725G | | Number of Individuals Covered | 3000 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $5,123 | | Total amount of fees paid to insurance company | USD $8,840 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $174,641 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,123 | | Amount paid for insurance broker fees | 2446 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | WINSTON FINANCIAL SERVICES |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 12 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 355 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $138,791 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 13 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 10425 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | 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 $503,785 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | LOAJ00238N |
| Policy instance | 14 |
| Insurance contract or identification number | LOAJ00238N | | Number of Individuals Covered | 541 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Total amount of commissions paid to insurance broker | USD $35,125 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $377,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,125 | | Insurance broker organization code? | 3 | | Insurance broker name | KRITZER CONSULTING SERVICES |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213N |
| Policy instance | 15 |
| Insurance contract or identification number | L1AK00213N | | Number of Individuals Covered | 5569 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $454,518 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,317,528 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $454,518 | | Insurance broker organization code? | 3 | | Insurance broker name | KRITZER CONSULTING SERVICES |
|
| FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 ) |
| Policy contract number | 3633 |
| Policy instance | 9 |
| Insurance contract or identification number | 3633 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 ) |
| Policy contract number | 75570 |
| Policy instance | 8 |
| Insurance contract or identification number | 75570 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,835 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 475069 |
| Policy instance | 7 |
| Insurance contract or identification number | 475069 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,082 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216772 |
| Policy instance | 11 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 314 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $7,350 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $202,125 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,350 | | Insurance broker organization code? | 3 | | Insurance broker name | DKG INSURANCE & FINANCIAL SERV INC, |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 10306-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 10306-01 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2013-12-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 402613G |
| Policy instance | 2 |
| Insurance contract or identification number | 402613G | | Number of Individuals Covered | 5560 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $10,321 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $206,410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,321 | | Insurance broker organization code? | 3 | | Insurance broker name | WINSTON FINANCIAL SERVICES |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L2AJ00214N |
| Policy instance | 3 |
| Insurance contract or identification number | L2AJ00214N | | Number of Individuals Covered | 134 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Total amount of commissions paid to insurance broker | USD $5,314 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $57,883 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,314 | | Insurance broker organization code? | 3 | | Insurance broker name | KRITZER CONSULTING SERVICES |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | ADDS-05438 |
| Policy instance | 4 |
| Insurance contract or identification number | ADDS-05438 | | Number of Individuals Covered | 28289 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $11,316 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $56,578 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,316 | | Insurance broker organization code? | 3 | | Insurance broker name | WINSTON FINANCIAL SVCS |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US013941 |
| Policy instance | 5 |
| Insurance contract or identification number | US013941 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $453 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $6,637 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $453 | | Insurance broker organization code? | 3 | | Insurance broker name | CENTERSTONE INSURANCE AND FINANCIAL |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0713160 |
| Policy instance | 6 |
| Insurance contract or identification number | 0713160 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | 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 $40,156 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | NR7903 |
| Policy instance | 8 |
| Insurance contract or identification number | NR7903 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $7,862 | | Total amount of fees paid to insurance company | USD $1,860 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,809,760 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,862 | | Amount paid for insurance broker fees | 1860 | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 3 | | Insurance broker name | DKG INSURANCE & FINANCIAL SERVICES |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US013941 |
| Policy instance | 7 |
| Insurance contract or identification number | US013941 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $414 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $6,898 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $414 | | Insurance broker organization code? | 3 | | Insurance broker name | CENTERSTONE INSURANCE AND FINANCIAL |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | ADDS-05438 |
| Policy instance | 6 |
| Insurance contract or identification number | ADDS-05438 | | Number of Individuals Covered | 29045 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $11,618 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $58,090 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,618 | | Insurance broker organization code? | 3 | | Insurance broker name | THE MAXON COMPANY |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | UW1023 |
| Policy instance | 5 |
| Insurance contract or identification number | UW1023 | | Number of Individuals Covered | 14929 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $340,669 | | Total amount of fees paid to insurance company | USD $11,263 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $85,382,589 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 10000 | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $340,669 | | Insurance broker name | DKG INSURANCE & FINANCIAL SVCS INC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 402613G |
| Policy instance | 4 |
| Insurance contract or identification number | 402613G | | Number of Individuals Covered | 5180 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $8,298 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $165,952 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,298 | | Insurance broker organization code? | 3 | | Insurance broker name | WINSTON FINANCIAL SERVICES |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 10306-01 |
| Policy instance | 3 |
| Insurance contract or identification number | 10306-01 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2012-12-01 | | Insurance policy end date | 2013-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,047 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | UW1081 |
| Policy instance | 2 |
| Insurance contract or identification number | UW1081 | | Number of Individuals Covered | 2758 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $55,389 | | Total amount of fees paid to insurance company | USD $6,768 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,539,212 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 6540 | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $55,389 | | Insurance broker name | DKG INSURANCE & FINANCIAL SERVICES |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 475069 |
| Policy instance | 10 |
| Insurance contract or identification number | 475069 | | Number of Individuals Covered | 221 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,558 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 ) |
| Policy contract number | 75570 |
| Policy instance | 11 |
| Insurance contract or identification number | 75570 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213N |
| Policy instance | 18 |
| Insurance contract or identification number | L1AK00213N | | Number of Individuals Covered | 5669 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $387,311 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,753,366 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $384,853 | | Insurance broker organization code? | 3 | | Insurance broker name | NATALIE CUCHEL |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | LOAJ00238N |
| Policy instance | 17 |
| Insurance contract or identification number | LOAJ00238N | | Number of Individuals Covered | 677 | | Insurance policy start date | 2013-02-01 | | Insurance policy end date | 2014-01-31 | | Total amount of commissions paid to insurance broker | USD $48,055 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $430,361 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $48,055 | | Insurance broker organization code? | 3 | | Insurance broker name | KRITZER CONSULTING SERVICES |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0713160 |
| Policy instance | 9 |
| Insurance contract or identification number | 0713160 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2012-11-01 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,309 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 16 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 8816 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | 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 $479,434 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 15 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 351 | | Insurance policy start date | 2012-11-01 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $161,906 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216772 |
| Policy instance | 14 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 287 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $198,402 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GRH-033725G |
| Policy instance | 13 |
| Insurance contract or identification number | GRH-033725G | | Number of Individuals Covered | 3000 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $8,596 | | Total amount of fees paid to insurance company | USD $7,956 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $213,712 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $632 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 7956 | | Additional information about fees paid to insurance broker | ADDITIONAL FEES | | Insurance broker name | WINSTON FINANCIAL SERVICES |
|
| FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 ) |
| Policy contract number | 3633 |
| Policy instance | 12 |
| Insurance contract or identification number | 3633 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 677747G |
| Policy instance | 1 |
| Insurance contract or identification number | 677747G | | Number of Individuals Covered | 25 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $3,302 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,436 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,302 | | Insurance broker organization code? | 3 | | Insurance broker name | WINSTON FINALCIAL SVCS |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 677747G |
| Policy instance | 1 |
| Insurance contract or identification number | 677747G | | Number of Individuals Covered | 27 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,031 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,610 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,419 | | Insurance broker organization code? | 3 | | Insurance broker name | WINSTON FINALCIAL SVCS |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213N |
| Policy instance | 18 |
| Insurance contract or identification number | L1AK00213N | | Number of Individuals Covered | 5834 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $225,612 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,152,057 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $225,612 | | Insurance broker organization code? | 3 | | Insurance broker name | KRITZER CONSULTING SERVICES |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | LOAJ00238N |
| Policy instance | 17 |
| Insurance contract or identification number | LOAJ00238N | | Number of Individuals Covered | 1135 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-01-31 | | Total amount of commissions paid to insurance broker | USD $44,918 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $443,886 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,918 | | Insurance broker organization code? | 3 | | Insurance broker name | KRITZER CONSULTING SERVICES |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 16 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 11433 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | 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 $526,251 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 15 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 442 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $201,503 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GRH-033725G |
| Policy instance | 13 |
| Insurance contract or identification number | GRH-033725G | | Number of Individuals Covered | 3000 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $10,830 | | Total amount of fees paid to insurance company | USD $8,644 | | Temporary Disability Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,581 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 8644 | | Additional information about fees paid to insurance broker | ADDITIONAL FEES | | Insurance broker name | STANLEY RUBENZAL |
|
| FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 ) |
| Policy contract number | 3633 |
| Policy instance | 12 |
| Insurance contract or identification number | 3633 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 ) |
| Policy contract number | 75570 |
| Policy instance | 11 |
| Insurance contract or identification number | 75570 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,032 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 475069 |
| Policy instance | 10 |
| Insurance contract or identification number | 475069 | | Number of Individuals Covered | 235 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,049 | | 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 | 0713160 |
| Policy instance | 9 |
| Insurance contract or identification number | 0713160 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | 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 $38,066 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 10306-02 |
| Policy instance | 8 |
| Insurance contract or identification number | 10306-02 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2011-12-01 | | Insurance policy end date | 2012-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,156 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3216772 |
| Policy instance | 14 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 307 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $212,702 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | UW1081 |
| Policy instance | 2 |
| Insurance contract or identification number | UW1081 | | Number of Individuals Covered | 2033 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $17,178 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,660,458 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,674 | | Insurance broker organization code? | 3 | | Insurance broker name | DKG INSURANCE & FINANCIAL SERVICES |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 10306-01 |
| Policy instance | 3 |
| Insurance contract or identification number | 10306-01 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2011-12-01 | | Insurance policy end date | 2012-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,475 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | UW1023 |
| Policy instance | 4 |
| Insurance contract or identification number | UW1023 | | Number of Individuals Covered | 19020 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $289,470 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $105,431,784 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $132,004 | | Insurance broker organization code? | 3 | | Insurance broker name | DKG INSURANCE & FINANCIAL SVCS INC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | ADDS-05438 |
| Policy instance | 5 |
| Insurance contract or identification number | ADDS-05438 | | Number of Individuals Covered | 28411 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $11,364 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $56,822 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,841 | | Insurance broker organization code? | 3 | | Insurance broker name | ERNEST E. MELE |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | NR7903 |
| Policy instance | 7 |
| Insurance contract or identification number | NR7903 | | Number of Individuals Covered | 211 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $7,923 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,822,080 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,229 | | Insurance broker organization code? | 3 | | Insurance broker name | DKG INSURANCE & FINANCIAL SERVICES |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US013941 |
| Policy instance | 6 |
| Insurance contract or identification number | US013941 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $706 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $10,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $706 | | Insurance broker organization code? | 3 | | Insurance broker name | CENTERSTONE INSURANCE AND FINANCIAL |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | LOAJ00238N |
| Policy instance | 18 |
| Insurance contract or identification number | LOAJ00238N | | Number of Individuals Covered | 1158 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $10,003 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $155,515 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | UW1023 |
| Policy instance | 5 |
| Insurance contract or identification number | UW1023 | | Number of Individuals Covered | 19708 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $338,537 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $112,256,410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 301199 |
| Policy instance | 1 |
| Insurance contract or identification number | 301199 | | Number of Individuals Covered | 5021 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $11,951 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $260,412 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | UW1081 |
| Policy instance | 2 |
| Insurance contract or identification number | UW1081 | | Number of Individuals Covered | 792 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $4,220 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,678,012 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 10306-01 |
| Policy instance | 3 |
| Insurance contract or identification number | 10306-01 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2010-12-01 | | Insurance policy end date | 2011-11-30 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,450 | | 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 | 4025683 |
| Policy instance | 4 |
| Insurance contract or identification number | 4025683 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $20,493 | | 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 | 0713160 |
| Policy instance | 10 |
| Insurance contract or identification number | 0713160 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | 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 $34,622 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 470569 |
| Policy instance | 11 |
| Insurance contract or identification number | 470569 | | Number of Individuals Covered | 243 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,372 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 05570-0001 |
| Policy instance | 12 |
| Insurance contract or identification number | 05570-0001 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,417 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 ) |
| Policy contract number | 3633 |
| Policy instance | 13 |
| Insurance contract or identification number | 3633 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GRH-33725 |
| Policy instance | 14 |
| Insurance contract or identification number | GRH-33725 | | Number of Individuals Covered | 3000 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $10,830 | | Total amount of fees paid to insurance company | USD $8,664 | | Temporary Disability Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3216772 |
| Policy instance | 15 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 331 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $786,241 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 16 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 461 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $148,573 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 17 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 10005 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | 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 $556,937 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPLEX INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11172 ) |
| Policy contract number | L1AK00213N |
| Policy instance | 19 |
| Insurance contract or identification number | L1AK00213N | | Number of Individuals Covered | 5675 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $256,282 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,823,599 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 10306-02 |
| Policy instance | 9 |
| Insurance contract or identification number | 10306-02 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-12-01 | | Insurance policy end date | 2011-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,558 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US013941 |
| Policy instance | 7 |
| Insurance contract or identification number | US013941 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $1,169 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $17,122 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | NR7903 |
| Policy instance | 8 |
| Insurance contract or identification number | NR7903 | | Number of Individuals Covered | 318 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $12,097 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,933,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | ADDS-05438 |
| Policy instance | 6 |
| Insurance contract or identification number | ADDS-05438 | | Number of Individuals Covered | 31366 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $12,547 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $62,732 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENERAL VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8518 |
| Policy instance | 16 |
| Insurance contract or identification number | 8518 | | Number of Individuals Covered | 11192 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $616,919 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | NR7903 |
| Policy instance | 6 |
| Insurance contract or identification number | NR7903 | | Number of Individuals Covered | 527 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $16,830 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $5,465,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 301199 |
| Policy instance | 5 |
| Insurance contract or identification number | 301199 | | Number of Individuals Covered | 4982 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $13,150 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | 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 | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $262,991 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | US013941 |
| Policy instance | 4 |
| Insurance contract or identification number | US013941 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,351 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $28,049 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | ADDS-05438 |
| Policy instance | 3 |
| Insurance contract or identification number | ADDS-05438 | | Number of Individuals Covered | 32544 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $13,017 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $65,088 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | UW1023 |
| Policy instance | 2 |
| Insurance contract or identification number | UW1023 | | Number of Individuals Covered | 22396 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $343,476 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $114,695,381 | | 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 | 0713160 |
| Policy instance | 8 |
| Insurance contract or identification number | 0713160 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2009-11-01 | | Insurance policy end date | 2010-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $36,918 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 475069 |
| Policy instance | 9 |
| Insurance contract or identification number | 475069 | | Number of Individuals Covered | 258 | | 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 $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $34,853 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-313-01 |
| Policy instance | 15 |
| Insurance contract or identification number | GG-313-01 | | Number of Individuals Covered | 405 | | Insurance policy start date | 2009-11-01 | | Insurance policy end date | 2010-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $169,396 |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3216772 |
| Policy instance | 14 |
| Insurance contract or identification number | 3216772 | | Number of Individuals Covered | 1294 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $912,852 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 1547-0002,9999 |
| Policy instance | 7 |
| Insurance contract or identification number | 1547-0002,9999 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2009-12-01 | | Insurance policy end date | 2010-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $21,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GRH-33725 |
| Policy instance | 13 |
| Insurance contract or identification number | GRH-33725 | | Number of Individuals Covered | 3000 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $10,830 | | Total amount of fees paid to insurance company | USD $8,664 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 1547-0001,8999 |
| Policy instance | 12 |
| Insurance contract or identification number | 1547-0001,8999 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2009-12-01 | | Insurance policy end date | 2010-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $5,767 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 ) |
| Policy contract number | 3633 |
| Policy instance | 11 |
| Insurance contract or identification number | 3633 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2009-12-01 | | Insurance policy end date | 2010-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | 05570-0001 |
| Policy instance | 10 |
| Insurance contract or identification number | 05570-0001 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $4,512 | | 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 | 4025683 |
| Policy instance | 1 |
| Insurance contract or identification number | 4025683 | | Number of Individuals Covered | 6 | | 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 $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $77,960 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
