DERR FLOORING COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DERR FLOORING COMPANY WELFARE BENEFIT TRUST
Measure | Date | Value |
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2022: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 143 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 139 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 140 |
Number of employers contributing to the scheme | 2022-01-01 | 0 |
2021: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 134 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 142 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 143 |
Number of employers contributing to the scheme | 2021-01-01 | 0 |
2020: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 133 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 133 |
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 | 133 |
Number of employers contributing to the scheme | 2020-01-01 | 0 |
2019: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 128 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 133 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 1 |
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 | 134 |
Number of employers contributing to the scheme | 2019-01-01 | 0 |
2018: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 129 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 128 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 1 |
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 | 129 |
Number of employers contributing to the scheme | 2018-01-01 | 0 |
2017: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 129 |
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 | 129 |
2016: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 125 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 127 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
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 | 127 |
2015: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 118 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 125 |
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 | 125 |
2014: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 118 |
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 | 118 |
2013: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 123 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 123 |
2012: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 112 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 115 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 115 |
2011: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 112 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
Total of all active and inactive participants | 2011-01-01 | 112 |
2010: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2010 401k membership |
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Total participants, beginning-of-year | 2010-01-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 115 |
Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
Total of all active and inactive participants | 2010-01-01 | 115 |
2009: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 123 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
Total of all active and inactive participants | 2009-01-01 | 123 |
2008: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2008 401k membership |
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Total participants, beginning-of-year | 2008-01-01 | 128 |
Total number of active participants reported on line 7a of the Form 5500 | 2008-01-01 | 123 |
Number of retired or separated participants receiving benefits | 2008-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2008-01-01 | 0 |
Total of all active and inactive participants | 2008-01-01 | 123 |
2007: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2007 401k membership |
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Total participants, beginning-of-year | 2007-01-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2007-01-01 | 128 |
Number of retired or separated participants receiving benefits | 2007-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2007-01-01 | 0 |
Total of all active and inactive participants | 2007-01-01 | 128 |
2006: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2006 401k membership |
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Total participants, beginning-of-year | 2006-01-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2006-01-01 | 127 |
Number of retired or separated participants receiving benefits | 2006-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2006-01-01 | 0 |
Total of all active and inactive participants | 2006-01-01 | 127 |
2005: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2005 401k membership |
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Total participants, beginning-of-year | 2005-01-01 | 120 |
Total number of active participants reported on line 7a of the Form 5500 | 2005-01-01 | 123 |
Number of retired or separated participants receiving benefits | 2005-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2005-01-01 | 0 |
Total of all active and inactive participants | 2005-01-01 | 123 |
2004: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2004 401k membership |
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Total participants, beginning-of-year | 2004-01-01 | 112 |
Total number of active participants reported on line 7a of the Form 5500 | 2004-01-01 | 120 |
Number of retired or separated participants receiving benefits | 2004-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2004-01-01 | 0 |
Total of all active and inactive participants | 2004-01-01 | 120 |
2003: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2003 401k membership |
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Total participants, beginning-of-year | 2003-01-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2003-01-01 | 112 |
Number of retired or separated participants receiving benefits | 2003-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2003-01-01 | 0 |
Total of all active and inactive participants | 2003-01-01 | 112 |
2002: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2002 401k membership |
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Total participants, beginning-of-year | 2002-01-01 | 117 |
Total number of active participants reported on line 7a of the Form 5500 | 2002-01-01 | 115 |
Number of retired or separated participants receiving benefits | 2002-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2002-01-01 | 0 |
Total of all active and inactive participants | 2002-01-01 | 115 |
2022: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2021: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2020: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2020 form 5500 responses |
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2019: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2019 form 5500 responses |
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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: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2018 form 5500 responses |
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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: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2017 form 5500 responses |
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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: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2015: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
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: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | No |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | No |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Submission has been amended | No |
2012-01-01 | This submission is the final filing | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-01-01 | Plan is a collectively bargained plan | No |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2011: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Submission has been amended | No |
2011-01-01 | This submission is the final filing | No |
2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-01-01 | Plan is a collectively bargained plan | No |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2010: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2010 form 5500 responses |
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2010-01-01 | Type of plan entity | Single employer plan |
2010-01-01 | Submission has been amended | No |
2010-01-01 | This submission is the final filing | No |
2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-01-01 | Plan is a collectively bargained plan | No |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
2009: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Submission has been amended | No |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-01-01 | Plan is a collectively bargained plan | No |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
2008: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2008 form 5500 responses |
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2008-01-01 | Type of plan entity | Single employer plan |
2008-01-01 | Submission has been amended | No |
2008-01-01 | This submission is the final filing | No |
2008-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2008-01-01 | Plan is a collectively bargained plan | No |
2008-01-01 | Plan funding arrangement – Insurance | Yes |
2008-01-01 | Plan benefit arrangement – Insurance | Yes |
2007: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2007 form 5500 responses |
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2007-01-01 | Type of plan entity | Single employer plan |
2007-01-01 | Submission has been amended | No |
2007-01-01 | This submission is the final filing | No |
2007-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2007-01-01 | Plan is a collectively bargained plan | No |
2007-01-01 | Plan funding arrangement – Insurance | Yes |
2007-01-01 | Plan benefit arrangement – Insurance | Yes |
2006: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2006 form 5500 responses |
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2006-01-01 | Type of plan entity | Single employer plan |
2006-01-01 | Submission has been amended | No |
2006-01-01 | This submission is the final filing | No |
2006-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2006-01-01 | Plan is a collectively bargained plan | No |
2006-01-01 | Plan funding arrangement – Insurance | Yes |
2006-01-01 | Plan benefit arrangement – Insurance | Yes |
2005: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2005 form 5500 responses |
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2005-01-01 | Type of plan entity | Single employer plan |
2005-01-01 | Submission has been amended | No |
2005-01-01 | This submission is the final filing | No |
2005-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2005-01-01 | Plan is a collectively bargained plan | No |
2005-01-01 | Plan funding arrangement – Insurance | Yes |
2005-01-01 | Plan benefit arrangement – Insurance | Yes |
2004: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2004 form 5500 responses |
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2004-01-01 | Type of plan entity | Single employer plan |
2004-01-01 | Submission has been amended | No |
2004-01-01 | This submission is the final filing | No |
2004-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2004-01-01 | Plan is a collectively bargained plan | No |
2004-01-01 | Plan funding arrangement – Insurance | Yes |
2004-01-01 | Plan benefit arrangement – Insurance | Yes |
2003: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2003 form 5500 responses |
---|
2003-01-01 | Type of plan entity | Single employer plan |
2003-01-01 | Submission has been amended | No |
2003-01-01 | This submission is the final filing | No |
2003-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2003-01-01 | Plan is a collectively bargained plan | No |
2003-01-01 | Plan funding arrangement – Insurance | Yes |
2003-01-01 | Plan benefit arrangement – Insurance | Yes |
2002: DERR FLOORING COMPANY WELFARE BENEFIT TRUST 2002 form 5500 responses |
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2002-01-01 | Type of plan entity | Single employer plan |
2002-01-01 | First time form 5500 has been submitted | Yes |
2002-01-01 | Submission has been amended | No |
2002-01-01 | This submission is the final filing | No |
2002-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2002-01-01 | Plan is a collectively bargained plan | No |
2002-01-01 | Plan funding arrangement – Insurance | Yes |
2002-01-01 | Plan benefit arrangement – Insurance | Yes |
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 390900 |
Policy instance | 3 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 125 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $35,870 | Total amount of fees paid to insurance company | USD $3,132 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,870 | Amount paid for insurance broker fees | 3132 | Additional information about fees paid to insurance broker | OVERRIDE/ NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
Policy contract number | 390900 |
Policy instance | 2 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 91 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $23,963 | Total amount of fees paid to insurance company | USD $681 | 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 $23,963 | Amount paid for insurance broker fees | 681 | Additional information about fees paid to insurance broker | OVERRIDE/ NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 537403 |
Policy instance | 1 |
Insurance contract or identification number | 537403 | Number of Individuals Covered | 139 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $9,839 | Total amount of fees paid to insurance company | USD $4,107 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $104,736 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,597 | Amount paid for insurance broker fees | 4107 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 537403 |
Policy instance | 1 |
Insurance contract or identification number | 537403 | Number of Individuals Covered | 142 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $9,588 | Total amount of fees paid to insurance company | USD $5,570 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $101,232 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,351 | Amount paid for insurance broker fees | 5570 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
Policy contract number | 390900 |
Policy instance | 2 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 99 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $24,273 | Total amount of fees paid to insurance company | USD $781 | 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 $24,273 | Amount paid for insurance broker fees | 781 | Additional information about fees paid to insurance broker | OVERRIDE/NON MONETARY COMMISSIONS | Insurance broker organization code? | 3 |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 390900 |
Policy instance | 3 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 129 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $35,696 | Total amount of fees paid to insurance company | USD $3,507 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,696 | Amount paid for insurance broker fees | 3507 | Additional information about fees paid to insurance broker | OVERRIDE/NON MONETARY COMMISSIONS | Insurance broker organization code? | 3 |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 390900 |
Policy instance | 4 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 117 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $258 | Total amount of fees paid to insurance company | USD $1,053 | Vision 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 $258 | Amount paid for insurance broker fees | 1053 | Additional information about fees paid to insurance broker | OVERRIDE/NON-MONETARY COMMISSIONS | Insurance broker organization code? | 3 |
|
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
Policy contract number | 390900 |
Policy instance | 3 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 107 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $19,198 | Total amount of fees paid to insurance company | USD $3,910 | 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 $19,198 | Amount paid for insurance broker fees | 3910 | Additional information about fees paid to insurance broker | OVERRIDE/NON-MONETARY COMMISSIONS | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 537403 |
Policy instance | 2 |
Insurance contract or identification number | 537403 | Number of Individuals Covered | 133 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $9,757 | Total amount of fees paid to insurance company | USD $3,389 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $105,588 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,547 | Amount paid for insurance broker fees | 3389 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 390900 |
Policy instance | 1 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 114 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $28,142 | Total amount of fees paid to insurance company | USD $6,679 | 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 $28,142 | Amount paid for insurance broker fees | 6679 | Additional information about fees paid to insurance broker | OVERRIDE/NON-MONETARY COMMISSIONS | Insurance broker organization code? | 3 |
|
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
Policy contract number | 390900 |
Policy instance | 3 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 104 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $20,999 | Total amount of fees paid to insurance company | USD $4,795 | 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 $20,999 | Amount paid for insurance broker fees | 4795 | Additional information about fees paid to insurance broker | OVERRIDE NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 537403 |
Policy instance | 2 |
Insurance contract or identification number | 537403 | Number of Individuals Covered | 134 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $8,837 | Total amount of fees paid to insurance company | USD $4,563 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $93,701 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,661 | Amount paid for insurance broker fees | 4563 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 390900 |
Policy instance | 1 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 123 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $27,293 | Total amount of fees paid to insurance company | USD $10,362 | Health Insurance Welfare Benefit | Yes | Vision 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 $27,293 | Amount paid for insurance broker fees | 10362 | Additional information about fees paid to insurance broker | OVERRIDE NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 390900 |
Policy instance | 1 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 125 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $25,337 | Total amount of fees paid to insurance company | USD $5,990 | Health Insurance Welfare Benefit | Yes | Vision 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 $25,337 | Amount paid for insurance broker fees | 5990 | Additional information about fees paid to insurance broker | OVERRIDE | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00537403 |
Policy instance | 2 |
Insurance contract or identification number | 00537403 | Number of Individuals Covered | 130 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $9,633 | Total amount of fees paid to insurance company | USD $2,802 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $104,253 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,431 | Amount paid for insurance broker fees | 2802 | Insurance broker organization code? | 3 |
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KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
Policy contract number | 390900 |
Policy instance | 3 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 102 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $21,294 | Total amount of fees paid to insurance company | USD $4,630 | 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 $21,294 | Amount paid for insurance broker fees | 4630 | Additional information about fees paid to insurance broker | OVERRIDE | Insurance broker organization code? | 3 |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 390900 |
Policy instance | 4 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 124 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $31,851 | Total amount of fees paid to insurance company | USD $10,732 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Welfare Benefit Premiums Paid to Carrier | USD $7,820 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,851 | Amount paid for insurance broker fees | 10732 | Additional information about fees paid to insurance broker | OVERRIDE/NON MONETARY COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | EMERSON REID |
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KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
Policy contract number | 390900 |
Policy instance | 3 |
Insurance contract or identification number | 390900 | Number of Individuals Covered | 94 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $20,037 | Total amount of fees paid to insurance company | USD $4,495 | 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 $20,037 | Amount paid for insurance broker fees | 4495 | Additional information about fees paid to insurance broker | OVERRIDE/NON MONETARY COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | EMERSON REID DBA TRA BENEFIT |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00537403 |
Policy instance | 2 |
Insurance contract or identification number | 00537403 | Number of Individuals Covered | 129 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $7,562 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $75,527 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,408 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | AMERIHEALTH ADMINISTRATORS INC |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5714812 |
Policy instance | 1 |
Insurance contract or identification number | 5714812 | Number of Individuals Covered | 360 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-02-28 | Total amount of commissions paid to insurance broker | USD $842 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $15,117 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $842 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | H & M FINANCIAL GROUP |
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