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HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 401k Plan overview

Plan NameHOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY
Plan identification number 504

HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY Benefits

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

401k Sponsoring company profile

GREATER NEW YORK MUTUAL INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:GREATER NEW YORK MUTUAL INSURANCE COMPANY
Employer identification number (EIN):135117400
NAIC Classification:524150

Additional information about GREATER NEW YORK MUTUAL INSURANCE COMPANY

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date: 1963-08-23
Company Identification Number: 733740
Legal Registered Office Address: 200 MADISON AVE

NEW YORK
United States of America (USA)
10016-3904

More information about GREATER NEW YORK MUTUAL INSURANCE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-01-01
5042021-01-01
5042020-01-01
5042019-01-01
5042018-01-01NANCY PEARLSTEIN NANCY PEARLSTEIN2019-06-26
5042017-01-01NANCY PEARLSTEIN NANCY PEARLSTEIN2018-07-06
5042016-01-01NANCY PEARLSTEIN NANCY PEARLSTEIN2017-07-17
5042015-01-01NANCY PEARLSTEIN NANCY PEARLSTEIN2016-07-22
5042014-01-01NANCY PEARLSTEIN NANCY PEARLSTEIN2015-07-15
5042013-01-01NANCY PEARLSTEIN NANCY PEARLSTEIN2014-07-02
5042012-01-01NANCY PEARLSTEIN
5042011-11-01NANCY PEARLSTEIN
5042010-11-01NANCY PEARLSTEIN
5042009-11-01NANCY PEARLSTEIN

Plan Statistics for HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY

401k plan membership statisitcs for HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY

Measure Date Value
2022: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2022 401k membership
Total participants, beginning-of-year2022-01-01281
Total number of active participants reported on line 7a of the Form 55002022-01-01286
Total of all active and inactive participants2022-01-01286
Total participants2022-01-01286
2021: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2021 401k membership
Total participants, beginning-of-year2021-01-01275
Total number of active participants reported on line 7a of the Form 55002021-01-01281
Total of all active and inactive participants2021-01-01281
Total participants2021-01-01281
2020: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2020 401k membership
Total participants, beginning-of-year2020-01-01260
Total number of active participants reported on line 7a of the Form 55002020-01-01275
Total of all active and inactive participants2020-01-01275
Total participants2020-01-01275
2019: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2019 401k membership
Total participants, beginning-of-year2019-01-01245
Total number of active participants reported on line 7a of the Form 55002019-01-01260
Total of all active and inactive participants2019-01-01260
Total participants2019-01-01260
2018: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2018 401k membership
Total participants, beginning-of-year2018-01-01244
Total number of active participants reported on line 7a of the Form 55002018-01-01245
Total of all active and inactive participants2018-01-01245
Total participants2018-01-01245
2017: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2017 401k membership
Total participants, beginning-of-year2017-01-01253
Total number of active participants reported on line 7a of the Form 55002017-01-01244
Total of all active and inactive participants2017-01-01244
Total participants2017-01-01244
2016: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2016 401k membership
Total participants, beginning-of-year2016-01-01257
Total number of active participants reported on line 7a of the Form 55002016-01-01253
Total of all active and inactive participants2016-01-01253
Total participants2016-01-01253
2015: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2015 401k membership
Total participants, beginning-of-year2015-01-01273
Total number of active participants reported on line 7a of the Form 55002015-01-01257
Total of all active and inactive participants2015-01-01257
Total participants2015-01-01257
2014: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2014 401k membership
Total participants, beginning-of-year2014-01-01328
Total number of active participants reported on line 7a of the Form 55002014-01-01273
Total of all active and inactive participants2014-01-01273
Total participants2014-01-01273
2013: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2013 401k membership
Total participants, beginning-of-year2013-01-01348
Total number of active participants reported on line 7a of the Form 55002013-01-01328
Total of all active and inactive participants2013-01-01328
Total participants2013-01-01328
2012: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2012 401k membership
Total participants, beginning-of-year2012-01-01350
Total number of active participants reported on line 7a of the Form 55002012-01-01348
Total of all active and inactive participants2012-01-01348
Total participants2012-01-01348
2011: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2011 401k membership
Total participants, beginning-of-year2011-11-01366
Total number of active participants reported on line 7a of the Form 55002011-11-01350
Total of all active and inactive participants2011-11-01350
Total participants2011-11-01350
2010: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2010 401k membership
Total participants, beginning-of-year2010-11-01371
Total number of active participants reported on line 7a of the Form 55002010-11-01366
Total of all active and inactive participants2010-11-01366
Total participants2010-11-01366
2009: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2009 401k membership
Total participants, beginning-of-year2009-11-01424
Total number of active participants reported on line 7a of the Form 55002009-11-01371
Total of all active and inactive participants2009-11-01371
Total participants2009-11-01371

Form 5500 Responses for HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY

2022: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Submission has been amendedNo
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2011-11-01Plan is a collectively bargained planNo
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan benefit arrangement – InsuranceYes
2010: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2010 form 5500 responses
2010-11-01Type of plan entitySingle employer plan
2010-11-01Submission has been amendedNo
2010-11-01This submission is the final filingNo
2010-11-01This return/report is a short plan year return/report (less than 12 months)No
2010-11-01Plan is a collectively bargained planNo
2010-11-01Plan funding arrangement – InsuranceYes
2010-11-01Plan benefit arrangement – InsuranceYes
2009: HOSPITALIZATION PLAN FOR EMPLOYEES OF GREATER NEW YORK MUTUAL INSURANCE COMPANY 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01First time form 5500 has been submittedYes
2009-11-01Submission has been amendedNo
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0314926
Policy instance 1
Insurance contract or identification number0314926
Number of Individuals Covered286
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $102,075
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?No
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 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 $2,556,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $85,070
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0314926
Policy instance 1
Insurance contract or identification number0314926
Number of Individuals Covered281
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $97,978
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?No
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 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 $2,457,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $97,978
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0314926
Policy instance 1
Insurance contract or identification number0314926
Number of Individuals Covered275
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $94,968
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?No
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 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 $2,382,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $94,968
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number031-4926
Policy instance 1
Insurance contract or identification number031-4926
Number of Individuals Covered260
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $89,264
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?No
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 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 $2,244,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $89,264
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number031-4926
Policy instance 1
Insurance contract or identification number031-4926
Number of Individuals Covered245
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $96,383
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?No
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 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 $2,151,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $96,383
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0314926
Policy instance 1
Insurance contract or identification number0314926
Number of Individuals Covered244
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $85,925
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?No
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $85,925
Insurance broker organization code?3
Insurance broker nameGENATT V LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number031-4926
Policy instance 1
Insurance contract or identification number031-4926
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $85,613
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 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 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 $1,756,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $85,613
Insurance broker organization code?3
Insurance broker nameKSL ASSOCIATES
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number314926
Policy instance 1
Insurance contract or identification number314926
Number of Individuals Covered273
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $90,756
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 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 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 $1,791,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,756
Insurance broker organization code?3
Insurance broker nameKSL ASSOCIATES
AETNA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number314296
Policy instance 1
Insurance contract or identification number314296
Number of Individuals Covered328
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $95,963
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 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 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 $1,923,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $95,963
Insurance broker organization code?3
Insurance broker nameKSL ASSOCIATES
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number314926
Policy instance 1
Insurance contract or identification number314926
Number of Individuals Covered348
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $95,028
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,805,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $190,055
Insurance broker organization code?3
Insurance broker nameKSL ASSOCIATES
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number314926
Policy instance 1
Insurance contract or identification number314926
Number of Individuals Covered296
Insurance policy start date2011-11-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $242,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 )
Policy contract number1GA0014000
Policy instance 2
Insurance contract or identification number1GA0014000
Number of Individuals Covered54
Insurance policy start date2011-11-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,821
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 )
Policy contract number1GA0014000
Policy instance 2
Insurance contract or identification number1GA0014000
Number of Individuals Covered55
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $27,886
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $348,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number279691
Policy instance 1
Insurance contract or identification number279691
Number of Individuals Covered311
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $40,779
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $286,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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