THE JUICE PLUS COMPANY, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan NSA, LLC MEDICAL GROUP BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2015: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 383 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 810 |
| Total of all active and inactive participants | 2015-01-01 | 810 |
| Total participants | 2015-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| 2014: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 363 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 383 |
| Total of all active and inactive participants | 2014-01-01 | 383 |
| Total participants | 2014-01-01 | 0 |
| 2013: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 356 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 363 |
| Total of all active and inactive participants | 2013-01-01 | 363 |
| Total participants | 2013-01-01 | 0 |
| 2012: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 341 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 356 |
| Total of all active and inactive participants | 2012-01-01 | 356 |
| Total participants | 2012-01-01 | 0 |
| 2011: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 333 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 341 |
| Total of all active and inactive participants | 2011-01-01 | 341 |
| Total participants | 2011-01-01 | 341 |
| 2010: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 383 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 333 |
| Total of all active and inactive participants | 2010-01-01 | 333 |
| Total participants | 2010-01-01 | 333 |
| 2009: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 386 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 383 |
| Total of all active and inactive participants | 2009-01-01 | 383 |
| Total participants | 2009-01-01 | 383 |
| 2015: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | Yes |
| 2015-01-01 | This submission is the final filing | Yes |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: NSA, LLC MEDICAL GROUP BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337885 |
| Policy instance | 1 |
| Insurance contract or identification number | 3337885 | | Number of Individuals Covered | 1066 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $120,667 | | Total amount of fees paid to insurance company | USD $16,590 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,060,192 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 118719 |
| Policy instance | 1 |
| Insurance contract or identification number | 118719 | | Number of Individuals Covered | 947 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $22,542 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,528 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,542 | | Insurance broker organization code? | 3 | | Insurance broker name | LIPSCOMB & PITTS COMPANY |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337885 |
| Policy instance | 2 |
| Insurance contract or identification number | 3337885 | | Number of Individuals Covered | 1061 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $69,600 | | Total amount of fees paid to insurance company | USD $34,930 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $612,185 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $69,600 | | Amount paid for insurance broker fees | 34930 | | Additional information about fees paid to insurance broker | INCENTIVE COMPENSATION PAYMENTS | | Insurance broker organization code? | 3 | | Insurance broker name | LIPSCOMB & PITTS COMPANY |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 118719 |
| Policy instance | 1 |
| Insurance contract or identification number | 118719 | | Number of Individuals Covered | 990 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $71,281 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,718 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,281 | | Insurance broker organization code? | 3 | | Insurance broker name | JAMES C. WRIGHT |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 118719 |
| Policy instance | 1 |
| Insurance contract or identification number | 118719 | | Number of Individuals Covered | 966 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $60,052 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,770 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $60,052 | | Insurance broker organization code? | 3 | | Insurance broker name | JAMES C. WRIGHT |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 118719 |
| Policy instance | 1 |
| Insurance contract or identification number | 118719 | | Number of Individuals Covered | 904 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $81,739 | | Health Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,784 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 118719 |
| Policy instance | 1 |
| Insurance contract or identification number | 118719 | | Number of Individuals Covered | 874 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $78,560 | | Health Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,246 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $78,560 | | Insurance broker organization code? | 3 | | Insurance broker name | JAMES C. WRIGHT |
|
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