BODEK AND RHODES, INC. has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2015: BODEK AND RHODES HEALTH PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 210 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 0 |
| Number of retired or separated participants receiving benefits | 2015-06-01 | 0 |
| Total of all active and inactive participants | 2015-06-01 | 0 |
| 2014: BODEK AND RHODES HEALTH PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-06-01 | 205 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 210 |
| Total of all active and inactive participants | 2014-06-01 | 210 |
| Total participants | 2014-06-01 | 210 |
| 2013: BODEK AND RHODES HEALTH PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-06-01 | 197 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 205 |
| Number of retired or separated participants receiving benefits | 2013-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-06-01 | 0 |
| Total of all active and inactive participants | 2013-06-01 | 205 |
| Total participants | 2013-06-01 | 205 |
| 2012: BODEK AND RHODES HEALTH PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-06-01 | 178 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 180 |
| Total of all active and inactive participants | 2012-06-01 | 180 |
| Total participants | 2012-06-01 | 180 |
| 2011: BODEK AND RHODES HEALTH PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-06-01 | 189 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 192 |
| Total of all active and inactive participants | 2011-06-01 | 192 |
| Total participants | 2011-06-01 | 192 |
| 2010: BODEK AND RHODES HEALTH PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-06-01 | 18 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-06-01 | 189 |
| Total of all active and inactive participants | 2010-06-01 | 189 |
| Total participants | 2010-06-01 | 189 |
| 2009: BODEK AND RHODES HEALTH PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-06-01 | 173 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 187 |
| Total of all active and inactive participants | 2009-06-01 | 187 |
| Total participants | 2009-06-01 | 187 |
| 2008: BODEK AND RHODES HEALTH PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-06-01 | 184 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-06-01 | 184 |
| Total of all active and inactive participants | 2008-06-01 | 184 |
| Total participants | 2008-06-01 | 184 |
| 2007: BODEK AND RHODES HEALTH PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-06-01 | 166 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-06-01 | 173 |
| Total of all active and inactive participants | 2007-06-01 | 173 |
| Total participants | 2007-06-01 | 173 |
| 2006: BODEK AND RHODES HEALTH PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-06-01 | 152 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-06-01 | 159 |
| Total of all active and inactive participants | 2006-06-01 | 159 |
| Total participants | 2006-06-01 | 159 |
| 2005: BODEK AND RHODES HEALTH PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-06-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-06-01 | 142 |
| Total of all active and inactive participants | 2005-06-01 | 142 |
| Total participants | 2005-06-01 | 142 |
| 2004: BODEK AND RHODES HEALTH PLAN 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-06-01 | 143 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-06-01 | 132 |
| Total of all active and inactive participants | 2004-06-01 | 132 |
| Total participants | 2004-06-01 | 132 |
| 2003: BODEK AND RHODES HEALTH PLAN 2003 401k membership |
|---|
| Total participants, beginning-of-year | 2003-06-01 | 150 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-06-01 | 143 |
| Total of all active and inactive participants | 2003-06-01 | 143 |
| Total participants | 2003-06-01 | 143 |
| 2002: BODEK AND RHODES HEALTH PLAN 2002 401k membership |
|---|
| Total participants, beginning-of-year | 2002-06-01 | 144 |
| Total number of active participants reported on line 7a of the Form 5500 | 2002-06-01 | 150 |
| Total of all active and inactive participants | 2002-06-01 | 150 |
| Total participants | 2002-06-01 | 150 |
| 2001: BODEK AND RHODES HEALTH PLAN 2001 401k membership |
|---|
| Total participants, beginning-of-year | 2001-06-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2001-06-01 | 144 |
| Total of all active and inactive participants | 2001-06-01 | 144 |
| Total participants | 2001-06-01 | 144 |
| 2000: BODEK AND RHODES HEALTH PLAN 2000 401k membership |
|---|
| Total participants, beginning-of-year | 2000-06-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2000-06-01 | 134 |
| Total of all active and inactive participants | 2000-06-01 | 134 |
| Total participants | 2000-06-01 | 134 |
| 1999: BODEK AND RHODES HEALTH PLAN 1999 401k membership |
|---|
| Total participants, beginning-of-year | 1999-06-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 1999-06-01 | 131 |
| Total of all active and inactive participants | 1999-06-01 | 131 |
| Total participants | 1999-06-01 | 131 |
| 1998: BODEK AND RHODES HEALTH PLAN 1998 401k membership |
|---|
| Total participants, beginning-of-year | 1998-06-01 | 133 |
| Total number of active participants reported on line 7a of the Form 5500 | 1998-06-01 | 132 |
| Total of all active and inactive participants | 1998-06-01 | 132 |
| Total participants | 1998-06-01 | 132 |
| 1997: BODEK AND RHODES HEALTH PLAN 1997 401k membership |
|---|
| Total participants, beginning-of-year | 1997-06-01 | 81 |
| Total number of active participants reported on line 7a of the Form 5500 | 1997-06-01 | 133 |
| Total of all active and inactive participants | 1997-06-01 | 133 |
| Total participants | 1997-06-01 | 133 |
| 2015: BODEK AND RHODES HEALTH PLAN 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Submission has been amended | No |
| 2015-06-01 | This submission is the final filing | Yes |
| 2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-06-01 | Plan is a collectively bargained plan | No |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: BODEK AND RHODES HEALTH PLAN 2014 form 5500 responses |
|---|
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Submission has been amended | No |
| 2014-06-01 | This submission is the final filing | No |
| 2014-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-06-01 | Plan is a collectively bargained plan | No |
| 2014-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: BODEK AND RHODES HEALTH PLAN 2013 form 5500 responses |
|---|
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | Submission has been amended | No |
| 2013-06-01 | This submission is the final filing | No |
| 2013-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-06-01 | Plan is a collectively bargained plan | No |
| 2013-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: BODEK AND RHODES HEALTH PLAN 2012 form 5500 responses |
|---|
| 2012-06-01 | Type of plan entity | Single employer plan |
| 2012-06-01 | Submission has been amended | No |
| 2012-06-01 | This submission is the final filing | No |
| 2012-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-06-01 | Plan is a collectively bargained plan | No |
| 2012-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: BODEK AND RHODES HEALTH PLAN 2011 form 5500 responses |
|---|
| 2011-06-01 | Type of plan entity | Single employer plan |
| 2011-06-01 | Submission has been amended | No |
| 2011-06-01 | This submission is the final filing | No |
| 2011-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-06-01 | Plan is a collectively bargained plan | No |
| 2011-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: BODEK AND RHODES HEALTH PLAN 2010 form 5500 responses |
|---|
| 2010-06-01 | Type of plan entity | Single employer plan |
| 2010-06-01 | Submission has been amended | No |
| 2010-06-01 | This submission is the final filing | No |
| 2010-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-06-01 | Plan is a collectively bargained plan | No |
| 2010-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: BODEK AND RHODES HEALTH PLAN 2009 form 5500 responses |
|---|
| 2009-06-01 | Type of plan entity | Single employer plan |
| 2009-06-01 | Submission has been amended | No |
| 2009-06-01 | This submission is the final filing | No |
| 2009-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-06-01 | Plan is a collectively bargained plan | No |
| 2009-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: BODEK AND RHODES HEALTH PLAN 2008 form 5500 responses |
|---|
| 2008-06-01 | Type of plan entity | Single employer plan |
| 2008-06-01 | Submission has been amended | No |
| 2008-06-01 | This submission is the final filing | No |
| 2008-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-06-01 | Plan is a collectively bargained plan | No |
| 2008-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: BODEK AND RHODES HEALTH PLAN 2007 form 5500 responses |
|---|
| 2007-06-01 | Type of plan entity | Single employer plan |
| 2007-06-01 | Submission has been amended | No |
| 2007-06-01 | This submission is the final filing | No |
| 2007-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-06-01 | Plan is a collectively bargained plan | No |
| 2007-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: BODEK AND RHODES HEALTH PLAN 2006 form 5500 responses |
|---|
| 2006-06-01 | Type of plan entity | Single employer plan |
| 2006-06-01 | Submission has been amended | No |
| 2006-06-01 | This submission is the final filing | No |
| 2006-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-06-01 | Plan is a collectively bargained plan | No |
| 2006-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2006-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: BODEK AND RHODES HEALTH PLAN 2005 form 5500 responses |
|---|
| 2005-06-01 | Type of plan entity | Single employer plan |
| 2005-06-01 | Submission has been amended | No |
| 2005-06-01 | This submission is the final filing | No |
| 2005-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-06-01 | Plan is a collectively bargained plan | No |
| 2005-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2005-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: BODEK AND RHODES HEALTH PLAN 2004 form 5500 responses |
|---|
| 2004-06-01 | Type of plan entity | Single employer plan |
| 2004-06-01 | Submission has been amended | No |
| 2004-06-01 | This submission is the final filing | No |
| 2004-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2004-06-01 | Plan is a collectively bargained plan | No |
| 2004-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2004-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2003: BODEK AND RHODES HEALTH PLAN 2003 form 5500 responses |
|---|
| 2003-06-01 | Type of plan entity | Single employer plan |
| 2003-06-01 | Submission has been amended | No |
| 2003-06-01 | This submission is the final filing | No |
| 2003-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2003-06-01 | Plan is a collectively bargained plan | No |
| 2003-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2003-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2002: BODEK AND RHODES HEALTH PLAN 2002 form 5500 responses |
|---|
| 2002-06-01 | Type of plan entity | Single employer plan |
| 2002-06-01 | Submission has been amended | No |
| 2002-06-01 | This submission is the final filing | No |
| 2002-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2002-06-01 | Plan is a collectively bargained plan | No |
| 2002-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2002-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2001: BODEK AND RHODES HEALTH PLAN 2001 form 5500 responses |
|---|
| 2001-06-01 | Type of plan entity | Single employer plan |
| 2001-06-01 | Submission has been amended | No |
| 2001-06-01 | This submission is the final filing | No |
| 2001-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2001-06-01 | Plan is a collectively bargained plan | No |
| 2001-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2000: BODEK AND RHODES HEALTH PLAN 2000 form 5500 responses |
|---|
| 2000-06-01 | Type of plan entity | Single employer plan |
| 2000-06-01 | Submission has been amended | No |
| 2000-06-01 | This submission is the final filing | No |
| 2000-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2000-06-01 | Plan is a collectively bargained plan | No |
| 2000-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2000-06-01 | Plan benefit arrangement – Insurance | Yes |
| 1999: BODEK AND RHODES HEALTH PLAN 1999 form 5500 responses |
|---|
| 1999-06-01 | Type of plan entity | Single employer plan |
| 1999-06-01 | Submission has been amended | No |
| 1999-06-01 | This submission is the final filing | No |
| 1999-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1999-06-01 | Plan is a collectively bargained plan | No |
| 1999-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 1999-06-01 | Plan benefit arrangement – Insurance | Yes |
| 1998: BODEK AND RHODES HEALTH PLAN 1998 form 5500 responses |
|---|
| 1998-06-01 | Type of plan entity | Single employer plan |
| 1998-06-01 | Submission has been amended | No |
| 1998-06-01 | This submission is the final filing | No |
| 1998-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1998-06-01 | Plan is a collectively bargained plan | No |
| 1998-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 1998-06-01 | Plan benefit arrangement – Insurance | Yes |
| 1997: BODEK AND RHODES HEALTH PLAN 1997 form 5500 responses |
|---|
| 1997-06-01 | Type of plan entity | Single employer plan |
| 1997-06-01 | Submission has been amended | No |
| 1997-06-01 | This submission is the final filing | No |
| 1997-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1997-06-01 | Plan is a collectively bargained plan | No |
| 1997-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 1997-06-01 | Plan benefit arrangement – Insurance | Yes |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3338019 |
| Policy instance | 1 |
| Insurance contract or identification number | 3338019 | | Number of Individuals Covered | 150 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $2,079 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $42,014 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,079 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID KUSHNER |
|
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
| Policy contract number | 357529 |
| Policy instance | 2 |
| Insurance contract or identification number | 357529 | | Number of Individuals Covered | 386 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $85,768 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $85,768 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID KUSHNER |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VARIOUS |
| Policy instance | 3 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 38 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $18,785 | | Total amount of fees paid to insurance company | USD $5,482 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $185,849 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,785 | | Amount paid for insurance broker fees | 5482 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | BWD AGENCY INC |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 278 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $22,016 | | Total amount of fees paid to insurance company | USD $3,167 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,016 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID KUSHNER |
|
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
| Policy contract number | 501 |
| Policy instance | 1 |
| Insurance contract or identification number | 501 | | Number of Individuals Covered | 381 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $120,939 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $120,939 | | Insurance broker name | DAVID KUSHNER |
|
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
| Policy contract number | 501 |
| Policy instance | 1 |
| Insurance contract or identification number | 501 | | Number of Individuals Covered | 403 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $83,901 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $83,901 | | Insurance broker name | DAVID KUSHNER |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 3232 |
| Policy instance | 2 |
| Insurance contract or identification number | 3232 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $3,477 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,477 | | Insurance broker name | DAVID KUSHNER |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 280 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $19,724 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,972,437 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID KUSHNER |
|
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
| Policy contract number | 501 |
| Policy instance | 1 |
| Insurance contract or identification number | 501 | | Number of Individuals Covered | 341 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $79,087 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $88,133 | | Insurance broker name | DAVID KUSHNER |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03232 |
| Policy instance | 2 |
| Insurance contract or identification number | 03232 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $11,933 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,933 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID KUSHNER |
|
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
| Policy contract number | 501 |
| Policy instance | 1 |
| Insurance contract or identification number | 501 | | Number of Individuals Covered | 361 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $73,186 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 3232 |
| Policy instance | 2 |
| Insurance contract or identification number | 3232 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $11,519 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
| Policy contract number | 501 |
| Policy instance | 1 |
| Insurance contract or identification number | 501 | | Number of Individuals Covered | 348 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $61,773 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $66,191 | | Insurance broker name | DAVID KUSHNER |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 3232 |
| Policy instance | 2 |
| Insurance contract or identification number | 3232 | | Number of Individuals Covered | 235 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $11,025 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,025 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID KUSHNER |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 3232 |
| Policy instance | 2 |
| Insurance contract or identification number | 3232 | | Number of Individuals Covered | 239 | | Insurance policy start date | 2009-01-01 | | Insurance policy end date | 2009-12-31 | | Total amount of commissions paid to insurance broker | USD $11,837 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,837 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID KUSHNER |
|
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
| Policy contract number | 501 |
| Policy instance | 1 |
| Insurance contract or identification number | 501 | | Number of Individuals Covered | 335 | | Insurance policy start date | 2009-06-01 | | Insurance policy end date | 2010-05-31 | | Total amount of commissions paid to insurance broker | USD $47,279 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,279 | | Insurance broker name | DAVID KUSHNER |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 3232 |
| Policy instance | 2 |
| Insurance contract or identification number | 3232 | | Number of Individuals Covered | 231 | | Insurance policy start date | 2008-01-01 | | Insurance policy end date | 2008-12-31 | | Total amount of commissions paid to insurance broker | USD $11,837 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,837 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID KUSHNER |
|
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
| Policy contract number | 501 |
| Policy instance | 1 |
| Insurance contract or identification number | 501 | | Number of Individuals Covered | 324 | | Insurance policy start date | 2008-06-01 | | Insurance policy end date | 2009-05-31 | | Total amount of commissions paid to insurance broker | USD $44,880 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $495 | | Insurance broker name | DAVID KUSHNER |
|
| KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
| Policy contract number | 501 |
| Policy instance | 1 |
| Insurance contract or identification number | 501 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2006-06-01 | | Insurance policy end date | 2007-05-31 | | Total amount of commissions paid to insurance broker | USD $38,706 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $38,706 | | Insurance broker name | DAVID KUSHNER |
|
