GREENBAUM, ROWE, SMITH & DAVIS LLP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN
401k plan membership statisitcs for GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN
Measure | Date | Value |
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2021: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-08-01 | 156 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-08-01 | 163 |
Number of retired or separated participants receiving benefits | 2021-08-01 | 0 |
Total of all active and inactive participants | 2021-08-01 | 163 |
2020: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-08-01 | 107 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-08-01 | 156 |
Number of retired or separated participants receiving benefits | 2020-08-01 | 0 |
Total of all active and inactive participants | 2020-08-01 | 156 |
2019: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-08-01 | 116 |
Number of retired or separated participants receiving benefits | 2019-08-01 | 107 |
Total of all active and inactive participants | 2019-08-01 | 107 |
2018: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-08-01 | 128 |
Number of retired or separated participants receiving benefits | 2018-08-01 | 116 |
Total of all active and inactive participants | 2018-08-01 | 116 |
2017: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-08-01 | 121 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-08-01 | 128 |
Number of retired or separated participants receiving benefits | 2017-08-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-08-01 | 0 |
Total of all active and inactive participants | 2017-08-01 | 128 |
2016: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-08-01 | 174 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-08-01 | 121 |
Number of retired or separated participants receiving benefits | 2016-08-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-08-01 | 0 |
Total of all active and inactive participants | 2016-08-01 | 121 |
2015: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-08-01 | 174 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-08-01 | 174 |
Number of retired or separated participants receiving benefits | 2015-08-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-08-01 | 0 |
Total of all active and inactive participants | 2015-08-01 | 174 |
2014: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-08-01 | 181 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-08-01 | 174 |
Number of retired or separated participants receiving benefits | 2014-08-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-08-01 | 0 |
Total of all active and inactive participants | 2014-08-01 | 174 |
2013: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-08-01 | 189 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-08-01 | 181 |
Number of retired or separated participants receiving benefits | 2013-08-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-08-01 | 0 |
Total of all active and inactive participants | 2013-08-01 | 181 |
2012: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-08-01 | 180 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-08-01 | 185 |
Number of retired or separated participants receiving benefits | 2012-08-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2012-08-01 | 2 |
Total of all active and inactive participants | 2012-08-01 | 189 |
2011: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-08-01 | 201 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-08-01 | 172 |
Number of retired or separated participants receiving benefits | 2011-08-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2011-08-01 | 5 |
Total of all active and inactive participants | 2011-08-01 | 180 |
2009: GREENBAUM, ROWE , SMITH & DAVIS LLP EMPLOYEES HOSPITALIZATION PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-08-01 | 181 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-08-01 | 193 |
Number of retired or separated participants receiving benefits | 2009-08-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2009-08-01 | 9 |
Total of all active and inactive participants | 2009-08-01 | 205 |
HEALTHCARE DENTAL, INC. (National Association of Insurance Commissioners NAIC id number: 11146 ) |
Policy contract number | 89552 |
Policy instance | 6 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 108 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $284 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | DENTAL MANAGED | Welfare Benefit Premiums Paid to Carrier | USD $6,951 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $284 | Insurance broker organization code? | 3 |
|
HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
Policy contract number | 85820 |
Policy instance | 5 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 107 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $1,271 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,710 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,271 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 407053 |
Policy instance | 4 |
Insurance contract or identification number | 407053 | Number of Individuals Covered | 163 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $3,405 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMET | Welfare Benefit Premiums Paid to Carrier | USD $42,557 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,405 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 89552 |
Policy instance | 3 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 10 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $4,188 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $102,494 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,188 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 104 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $25,575 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,967,823 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,575 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 106 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $6,377 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $435,202 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,377 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 110 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $8,417 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $579,167 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,417 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 107 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $26,601 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,056,326 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,601 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 89552 |
Policy instance | 3 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 9 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $4,321 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $103,487 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,321 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 407053 |
Policy instance | 4 |
Insurance contract or identification number | 407053 | Number of Individuals Covered | 156 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $3,356 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMET | Welfare Benefit Premiums Paid to Carrier | USD $41,953 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,356 | Insurance broker organization code? | 3 |
|
HEALTHCARE DENTAL, INC. (National Association of Insurance Commissioners NAIC id number: 11146 ) |
Policy contract number | 89552 |
Policy instance | 6 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 113 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $278 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | DENTAL MANAGED | Welfare Benefit Premiums Paid to Carrier | USD $6,654 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $278 | Insurance broker organization code? | 3 |
|
HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
Policy contract number | 85820 |
Policy instance | 5 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 112 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $1,247 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,529 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,247 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 102 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $7,995 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $496,550 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,995 | Insurance broker organization code? | 3 |
|
HEALTHCARE DENTAL, INC. (National Association of Insurance Commissioners NAIC id number: 11146 ) |
Policy contract number | 89552 |
Policy instance | 6 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 9 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $272 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | DENTAL MANAGED | Welfare Benefit Premiums Paid to Carrier | USD $6,733 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $272 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 103 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $27,103 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,084,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,103 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 89552 |
Policy instance | 3 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 107 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $4,222 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $105,065 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,222 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 407053 |
Policy instance | 4 |
Insurance contract or identification number | 407053 | Number of Individuals Covered | 146 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-11-01 | Total amount of commissions paid to insurance broker | USD $2,570 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMET | Welfare Benefit Premiums Paid to Carrier | USD $32,121 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,570 | Insurance broker organization code? | 3 |
|
HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
Policy contract number | 85820 |
Policy instance | 5 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 107 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $1,087 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,929 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,087 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 104 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $32,400 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,972,288 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,400 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 102 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $8,975 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $553,352 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,975 | Insurance broker organization code? | 3 |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 89552 |
Policy instance | 3 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 106 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $4,242 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $103,926 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,242 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 407053 |
Policy instance | 4 |
Insurance contract or identification number | 407053 | Number of Individuals Covered | 162 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-11-01 | Total amount of commissions paid to insurance broker | USD $2,794 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMET | Welfare Benefit Premiums Paid to Carrier | USD $34,922 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,794 | Insurance broker organization code? | 3 |
|
HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
Policy contract number | 85820 |
Policy instance | 5 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 101 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $1,016 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,121 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,016 | Insurance broker organization code? | 3 |
|
HEALTHCARE DENTAL, INC. (National Association of Insurance Commissioners NAIC id number: 11146 ) |
Policy contract number | 89552 |
Policy instance | 6 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 10 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $309 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | DENTAL MANAGED | Welfare Benefit Premiums Paid to Carrier | USD $7,576 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $309 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 407053 |
Policy instance | 4 |
Insurance contract or identification number | 407053 | Number of Individuals Covered | 117 | Insurance policy start date | 2016-11-01 | Insurance policy end date | 2017-11-01 | Total amount of commissions paid to insurance broker | USD $2,385 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMET | Welfare Benefit Premiums Paid to Carrier | USD $29,811 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 89552 |
Policy instance | 3 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 128 | Insurance policy start date | 2016-11-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $4,695 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $119,594 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 124 | Insurance policy start date | 2016-11-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $10,012 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $545,879 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 123 | Insurance policy start date | 2016-11-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $40,893 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,882,616 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 127 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-10-31 | Total amount of commissions paid to insurance broker | USD $10,586 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $410,443 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,158 | Insurance broker organization code? | 3 | Insurance broker name | STRATFORD FINANCIAL GROUP, INC. |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 124 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-10-31 | Total amount of commissions paid to insurance broker | USD $47,475 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,802,919 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,677 | Insurance broker organization code? | 3 | Insurance broker name | STRATFORD FINANCIAL GROUP, INC. |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 89552 |
Policy instance | 3 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 115 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-10-31 | Total amount of commissions paid to insurance broker | USD $4,805 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $126,412 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,455 | Insurance broker organization code? | 3 | Insurance broker name | STRATFORD FINANCIAL GROUP, INC. |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 407053 |
Policy instance | 4 |
Insurance contract or identification number | 407053 | Number of Individuals Covered | 118 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-11-01 | Total amount of commissions paid to insurance broker | USD $2,502 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMET | Welfare Benefit Premiums Paid to Carrier | USD $31,276 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,502 | Insurance broker organization code? | 3 | Insurance broker name | STRATFORD FINANCIAL GROUP, INC. |
|
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 89552 |
Policy instance | 3 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 127 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $4,762 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $123,123 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,762 | Insurance broker organization code? | 3 | Insurance broker name | STRATFORD FINANCIAL GROUP, INC. |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 867404G |
Policy instance | 4 |
Insurance contract or identification number | 867404G | Number of Individuals Covered | 174 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $2,121 | 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 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $26,510 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,121 | Insurance broker organization code? | 3 | Insurance broker name | STRATFORD FINANCIAL GROUP, INC. |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 129 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $10,663 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $352,629 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,663 | Insurance broker organization code? | 3 | Insurance broker name | STRATFORD FINANCIAL GROUP, INC. |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 129 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $47,988 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,811,710 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $47,988 | Insurance broker organization code? | 3 | Insurance broker name | STRATFORD FINANCIAL GROUP, INC. |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 130 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $10,764 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $334,466 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,890 | Insurance broker organization code? | 3 | Insurance broker name | MICHAEL CHODORCOFF |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 89552 |
Policy instance | 3 |
Insurance contract or identification number | 89552 | Number of Individuals Covered | 130 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $4,843 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $126,669 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,647 | Insurance broker organization code? | 3 | Insurance broker name | MICHAEL CHODORCOFF |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 867404G |
Policy instance | 4 |
Insurance contract or identification number | 867404G | Number of Individuals Covered | 179 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $2,134 | 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 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $26,671 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,943 | Insurance broker organization code? | 3 | Insurance broker name | MICHAEL CHODORCOFF |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 130 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $52,097 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,552,013 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $42,974 | Insurance broker organization code? | 3 | Insurance broker name | MICHAEL CHODORCOFF |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 867404G |
Policy instance | 4 |
Insurance contract or identification number | 867404G | Number of Individuals Covered | 184 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $1,943 | 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 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $24,286 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,943 | Insurance broker organization code? | 3 | Insurance broker name | MICHAEL CHODORCOFF |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 089552 |
Policy instance | 3 |
Insurance contract or identification number | 089552 | Number of Individuals Covered | 138 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $5,057 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $137,803 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,057 | Insurance broker organization code? | 3 | Insurance broker name | MICHAEL CHODORCOFF |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 134 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $52,285 | 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 | Were dividends or retroactive rate refunds paid as a credit? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,493,167 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52,285 | Insurance broker organization code? | 3 | Insurance broker name | MICHAEL CHODORCOFF |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 134 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $10,827 | 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 | Were dividends or retroactive rate refunds paid as a credit? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $309,210 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,827 | Insurance broker organization code? | 3 | Insurance broker name | MICHAEL CHODORCOFF |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 867404G |
Policy instance | 4 |
Insurance contract or identification number | 867404G | Number of Individuals Covered | 173 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $1,753 | 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 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $21,911 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 089552 |
Policy instance | 3 |
Insurance contract or identification number | 089552 | Number of Individuals Covered | 118 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $4,674 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $117,978 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 133 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $53,623 | 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 | Were dividends or retroactive rate refunds paid as a credit? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,530,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 137 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $10,858 | 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 | Were dividends or retroactive rate refunds paid as a credit? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $309,863 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 089552 |
Policy instance | 4 |
Insurance contract or identification number | 089552 | Number of Individuals Covered | 153 | Insurance policy start date | 2009-11-01 | Insurance policy end date | 2010-10-31 | Total amount of commissions paid to insurance broker | USD $4,876 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $130,377 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 581334 |
Policy instance | 3 |
Insurance contract or identification number | 581334 | Number of Individuals Covered | 0 | Insurance policy start date | 2009-11-01 | Insurance policy end date | 2010-11-01 | Total amount of commissions paid to insurance broker | USD $411 | 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 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $2,348 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 2 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 146 | Insurance policy start date | 2009-11-01 | Insurance policy end date | 2010-10-31 | Total amount of commissions paid to insurance broker | USD $55,218 | 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 | Were dividends or retroactive rate refunds paid as a credit? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,385,424 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 85820 |
Policy instance | 1 |
Insurance contract or identification number | 85820 | Number of Individuals Covered | 149 | Insurance policy start date | 2009-11-01 | Insurance policy end date | 2010-10-31 | Total amount of commissions paid to insurance broker | USD $12,614 | 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 | Were dividends or retroactive rate refunds paid as a credit? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $316,628 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 867404G |
Policy instance | 5 |
Insurance contract or identification number | 867404G | Number of Individuals Covered | 185 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $11,607 | 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 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $25,491 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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