A.W. HOLDINGS, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN
401k plan membership statisitcs for ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN
| Measure | Date | Value |
|---|
| 2022: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 934 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 940 |
| Total of all active and inactive participants | 2022-01-01 | 940 |
| Total participants | 2022-01-01 | 940 |
| 2021: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 985 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 934 |
| Total of all active and inactive participants | 2021-01-01 | 934 |
| Total participants | 2021-01-01 | 934 |
| 2020: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 856 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 985 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 985 |
| 2019: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 887 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 856 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 856 |
| 2018: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 802 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 887 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 887 |
| 2017: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 809 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 802 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 802 |
| 2016: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 1,706 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 792 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 17 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 809 |
| 2015: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 1,832 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 1,706 |
| 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 |
| Total of all active and inactive participants | 2015-01-01 | 1,706 |
| 2014: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 1,733 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 1,832 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 1,832 |
| 2013: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 1,549 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 1,733 |
| Total of all active and inactive participants | 2013-01-01 | 1,733 |
| 2012: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 1,556 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 1,549 |
| Total of all active and inactive participants | 2012-01-01 | 1,549 |
| 2011: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 1,261 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 1,556 |
| Total of all active and inactive participants | 2011-01-01 | 1,556 |
| 2009: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 979 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1,234 |
| Total of all active and inactive participants | 2009-01-01 | 1,234 |
| 2022: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES 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: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES 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: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES 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: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES 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 |
| 2009: ANTHONY WAYNE SERVICES GROUP MEDICAL SERVICES PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G00618906 |
| Policy instance | 5 |
| Insurance contract or identification number | G00618906 | | Number of Individuals Covered | 1910 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $6,417 | | Total amount of fees paid to insurance company | USD $1,833 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $45,834 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1833 | | Additional information about fees paid to insurance broker | OTHER FEES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $6,417 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E5240197 |
| Policy instance | 3 |
| Insurance contract or identification number | E5240197 | | Number of Individuals Covered | 586 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $109,451 | | Total amount of fees paid to insurance company | USD $6,885 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $503,041 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,390 | | Amount paid for insurance broker fees | 2881 | | Additional information about fees paid to insurance broker | OTHER FEES | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417005414104 |
| Policy instance | 2 |
| Insurance contract or identification number | 417005414104 | | Number of Individuals Covered | 813 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,086 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 921014 |
| Policy instance | 1 |
| Insurance contract or identification number | 921014 | | Number of Individuals Covered | 989 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $143,078 | | Total amount of fees paid to insurance company | USD $7,609 | | Welfare Benefit Premiums Paid to Carrier | USD $1,332,069 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,539 | | Amount paid for insurance broker fees | 7609 | | Additional information about fees paid to insurance broker | OTHER FEES | | Insurance broker organization code? | 3 |
|
| STHEALTH/CHARTIS (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 417002414104 |
| Policy instance | 1 |
| Insurance contract or identification number | 417002414104 | | Number of Individuals Covered | 934 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2022-01-01 | | Welfare Benefit Premiums Paid to Carrier | USD $1,339,343 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G00618906 |
| Policy instance | 2 |
| Insurance contract or identification number | G00618906 | | Number of Individuals Covered | 1853 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $6,939 | | Total amount of fees paid to insurance company | USD $1,983 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $49,564 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1983 | | Additional information about fees paid to insurance broker | OTHER FEES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $6,939 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E5240197 |
| Policy instance | 3 |
| Insurance contract or identification number | E5240197 | | Number of Individuals Covered | 552 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $100,823 | | Total amount of fees paid to insurance company | USD $9,001 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D, HOSPITAL INDEMNITY, CRIT ILL | | Welfare Benefit Premiums Paid to Carrier | USD $465,785 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $60,521 | | Amount paid for insurance broker fees | 3436 | | Additional information about fees paid to insurance broker | OTHER FEES | | Insurance broker organization code? | 3 |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00618906 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00618906 | | Number of Individuals Covered | 2180 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $7,311 | | Total amount of fees paid to insurance company | USD $2,250 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $52,220 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,311 | | Additional information about fees paid to insurance broker | PAID WRITING COMMISSION | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2250 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 921014 |
| Policy instance | 1 |
| Insurance contract or identification number | 921014 | | Number of Individuals Covered | 985 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $123,272 | | Welfare Benefit Premiums Paid to Carrier | USD $1,243,565 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $123,272 | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E5240197 |
| Policy instance | 4 |
| Insurance contract or identification number | E5240197 | | Number of Individuals Covered | 476 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $27,609 | | Total amount of fees paid to insurance company | USD $1,489 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $61,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,711 | | Additional information about fees paid to insurance broker | EMPLOYEE PAID POLICIES | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 904 |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00618906 |
| Policy instance | 3 |
| Insurance contract or identification number | G 00618906 | | Number of Individuals Covered | 1940 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,295 | | Total amount of fees paid to insurance company | USD $820 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $16,396 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,295 | | Additional information about fees paid to insurance broker | PAID WRITING COMMISSION | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 820 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 921014 |
| Policy instance | 2 |
| Insurance contract or identification number | 921014 | | Number of Individuals Covered | 966 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $107,517 | | Welfare Benefit Premiums Paid to Carrier | USD $1,075,168 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $107,517 | | Insurance broker organization code? | 3 |
|
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 000007036 |
| Policy instance | 1 |
| Insurance contract or identification number | 000007036 | | Number of Individuals Covered | 856 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $-2,193 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 000007036 |
| Policy instance | 1 |
| Insurance contract or identification number | 000007036 | | Number of Individuals Covered | 887 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,251,600 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 000007036 |
| Policy instance | 1 |
| Insurance contract or identification number | 000007036 | | Number of Individuals Covered | 802 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,199,661 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H70353 |
| Policy instance | 1 |
| Insurance contract or identification number | H70353 | | Number of Individuals Covered | 1706 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $9,266 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $174,250 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,266 | | Insurance broker organization code? | 3 | | Insurance broker name | USI MIDWEST LLC |
|
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 000007036 |
| Policy instance | 2 |
| Insurance contract or identification number | 000007036 | | Number of Individuals Covered | 780 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,006,442 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H70353 |
| Policy instance | 1 |
| Insurance contract or identification number | H70353 | | Number of Individuals Covered | 1832 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $10,085 | | Total amount of fees paid to insurance company | USD $1,032 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $206,579 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,356 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1032 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
|
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 000007036 |
| Policy instance | 2 |
| Insurance contract or identification number | 000007036 | | Number of Individuals Covered | 772 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $927,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H70353 |
| Policy instance | 1 |
| Insurance contract or identification number | H70353 | | Number of Individuals Covered | 1733 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $9,766 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $194,043 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,766 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
|
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 000007036 |
| Policy instance | 2 |
| Insurance contract or identification number | 000007036 | | Number of Individuals Covered | 765 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H70353 |
| Policy instance | 1 |
| Insurance contract or identification number | H70353 | | Number of Individuals Covered | 1549 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $8,954 | | Total amount of fees paid to insurance company | USD $1,990 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $162,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,954 | | Amount paid for insurance broker fees | 1990 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
|
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 000007036 |
| Policy instance | 2 |
| Insurance contract or identification number | 000007036 | | Number of Individuals Covered | 672 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
|
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 000007036 |
| Policy instance | 2 |
| Insurance contract or identification number | 000007036 | | Number of Individuals Covered | 662 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H70353 |
| Policy instance | 1 |
| Insurance contract or identification number | H70353 | | Number of Individuals Covered | 1556 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $7,642 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $112,656 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 000007036 |
| Policy instance | 1 |
| Insurance contract or identification number | 000007036 | | Number of Individuals Covered | 669 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $31,910 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | 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 $31,910 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 677072G |
| Policy instance | 2 |
| Insurance contract or identification number | 677072G | | Number of Individuals Covered | 1261 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $12,208 | | Total amount of fees paid to insurance company | USD $4,756 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $190,914 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,208 | | Amount paid for insurance broker fees | 4756 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
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