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MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 401k Plan overview

Plan NameMEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF
Plan identification number 530

MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

ST. THOMAS AQUINAS COLLEGE has sponsored the creation of one or more 401k plans.

Company Name:ST. THOMAS AQUINAS COLLEGE
Employer identification number (EIN):132513162
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5302021-04-01
5302020-04-01
5302019-04-01
5302018-04-01
5302017-04-01MARIA COUPE
5302016-04-01MARIA COUPE
5302015-04-01MARIA COUPE
5302014-04-01PATRICIA PACCHIANA
5302013-04-01PATRICIA PACCHIANA
5302012-04-01PATRICIA PACCHIANA
5302011-04-01PATRICIA PACCHIANA
5302009-04-01PATRICIA PACCHIANA

Plan Statistics for MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF

401k plan membership statisitcs for MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF

Measure Date Value
2021: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2021 401k membership
Total participants, beginning-of-year2021-04-01225
Total number of active participants reported on line 7a of the Form 55002021-04-01247
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01247
Total participants2021-04-01247
2020: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2020 401k membership
Total participants, beginning-of-year2020-04-01223
Total number of active participants reported on line 7a of the Form 55002020-04-01225
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01225
Total participants2020-04-01225
2019: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2019 401k membership
Total participants, beginning-of-year2019-04-01246
Total number of active participants reported on line 7a of the Form 55002019-04-01223
Total of all active and inactive participants2019-04-01223
Total participants2019-04-01223
2018: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2018 401k membership
Total participants, beginning-of-year2018-04-01251
Total number of active participants reported on line 7a of the Form 55002018-04-01246
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-04-010
Total participants2018-04-01246
Number of participants with account balances2018-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-04-010
2017: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2017 401k membership
Total participants, beginning-of-year2017-04-01263
Total number of active participants reported on line 7a of the Form 55002017-04-01251
Number of retired or separated participants receiving benefits2017-04-010
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01251
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-04-010
Total participants2017-04-01251
Number of participants with account balances2017-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-04-010
2016: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2016 401k membership
Total participants, beginning-of-year2016-04-01182
Total number of active participants reported on line 7a of the Form 55002016-04-01263
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01263
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-04-010
Total participants2016-04-01263
Number of participants with account balances2016-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-04-010
2015: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2015 401k membership
Total participants, beginning-of-year2015-04-01200
Total number of active participants reported on line 7a of the Form 55002015-04-01182
Number of retired or separated participants receiving benefits2015-04-010
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-04-010
Total participants2015-04-01182
Number of participants with account balances2015-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-04-010
2014: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2014 401k membership
Total participants, beginning-of-year2014-04-01237
Total number of active participants reported on line 7a of the Form 55002014-04-01200
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-01200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-04-010
Total participants2014-04-01200
Number of participants with account balances2014-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-04-010
2013: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2013 401k membership
Total participants, beginning-of-year2013-04-01237
Total number of active participants reported on line 7a of the Form 55002013-04-01237
Number of retired or separated participants receiving benefits2013-04-010
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-01237
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-04-010
Total participants2013-04-01237
Number of participants with account balances2013-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-04-010
2012: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2012 401k membership
Total participants, beginning-of-year2012-04-01238
Total number of active participants reported on line 7a of the Form 55002012-04-01237
Number of retired or separated participants receiving benefits2012-04-010
Number of other retired or separated participants entitled to future benefits2012-04-010
Total of all active and inactive participants2012-04-01237
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-04-010
Total participants2012-04-01237
Number of participants with account balances2012-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-04-010
2011: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2011 401k membership
Total participants, beginning-of-year2011-04-01229
Total number of active participants reported on line 7a of the Form 55002011-04-01238
Number of retired or separated participants receiving benefits2011-04-010
Number of other retired or separated participants entitled to future benefits2011-04-010
Total of all active and inactive participants2011-04-01238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-04-010
Total participants2011-04-01238
Number of participants with account balances2011-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-04-010
2009: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2009 401k membership
Total participants, beginning-of-year2009-04-01227
Total number of active participants reported on line 7a of the Form 55002009-04-01235
Number of retired or separated participants receiving benefits2009-04-010
Number of other retired or separated participants entitled to future benefits2009-04-010
Total of all active and inactive participants2009-04-01235
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-04-010
Total participants2009-04-01235
Number of participants with account balances2009-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-04-010

Form 5500 Responses for MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF

2021: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)No
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes
2009: MEDICAL INSURANCE FOR FACULTY, ADMINISTRATION AND STAFF 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedNo
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0880695
Policy instance 1
Insurance contract or identification number0880695
Number of Individuals Covered247
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $5,565
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $127,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $5,565
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0880695
Policy instance 1
Insurance contract or identification number0880695
Number of Individuals Covered225
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $5,392
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $114,777
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $5,392
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0880695
Policy instance 1
Insurance contract or identification number0880695
Number of Individuals Covered223
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $12,621
Total amount of fees paid to insurance companyUSD $1,815
Are there contracts with allocated funds for individual policies?0
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $120,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $1,621
Amount paid for insurance broker fees1815
Additional information about fees paid to insurance brokerPM KP BONUS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0880695
Policy instance 1
Insurance contract or identification number0880695
Number of Individuals Covered246
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $87,697
Total amount of fees paid to insurance companyUSD $22,247
Are there contracts with allocated funds for individual policies?0
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $2,368,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $87,697
Amount paid for insurance broker fees22247
Additional information about fees paid to insurance brokerKEY PRODUCER BONUS DEC 2018 PM KP BONUS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0880695
Policy instance 1
Insurance contract or identification number0880695
Number of Individuals Covered251
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $84,959
Total amount of fees paid to insurance companyUSD $21,336
Are there contracts with allocated funds for individual policies?0
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $229,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $84,959
Amount paid for insurance broker fees21336
Additional information about fees paid to insurance brokerPM KP BONUS
Insurance broker nameGERARD B TRACY ASSOCIATES INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 )
Policy contract number0880695HNO
Policy instance 1
Insurance contract or identification number0880695HNO
Number of Individuals Covered182
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $64,386
Total amount of fees paid to insurance companyUSD $18,093
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $1,806,644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $64,386
Amount paid for insurance broker fees18093
Additional information about fees paid to insurance brokerPM KP BONUS
Insurance broker nameGERARD B TRACY ASSOCIATES INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 )
Policy contract number0880695HNO
Policy instance 1
Insurance contract or identification number0880695HNO
Number of Individuals Covered200
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $67,412
Total amount of fees paid to insurance companyUSD $18,078
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $1,782,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $67,412
Amount paid for insurance broker fees18078
Additional information about fees paid to insurance brokerPM KP BONUS
Insurance broker nameGERARD B TRACY ASSOCIATES INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 )
Policy contract number0880695HNO
Policy instance 1
Insurance contract or identification number0880695HNO
Number of Individuals Covered237
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $78,760
Total amount of fees paid to insurance companyUSD $18,438
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $2,107,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $78,760
Amount paid for insurance broker fees18438
Additional information about fees paid to insurance brokerPM KP BONUS
Insurance broker nameGERARD B TRACY ASSOCIATES INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 )
Policy contract numberUS097663
Policy instance 1
Insurance contract or identification numberUS097663
Number of Individuals Covered237
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $76,021
Total amount of fees paid to insurance companyUSD $20,425
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Welfare Benefit Premiums Paid to CarrierUSD $1,879,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $76,021
Amount paid for insurance broker fees20425
Additional information about fees paid to insurance brokerPM KP BONUS
Insurance broker nameGERARD B TRACY ASSOCIATES INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 )
Policy contract numberUS097663
Policy instance 1
Insurance contract or identification numberUS097663
Number of Individuals Covered238
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $72,034
Total amount of fees paid to insurance companyUSD $18,773
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Welfare Benefit Premiums Paid to CarrierUSD $1,892,266
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 )
Policy contract numberUS097663
Policy instance 1
Insurance contract or identification numberUS097663
Number of Individuals Covered229
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $68,053
Total amount of fees paid to insurance companyUSD $17,827
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Health Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $1,790,632
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractPRE-PAID COMPREHENSIVE
Commission paid to Insurance BrokerUSD $68,053
Amount paid for insurance broker fees17827
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker nameGERARD B TRACY ASSOCIATES INC

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