OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN
401k plan membership statisitcs for OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN
Measure | Date | Value |
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2022: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-07-01 | 110 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 115 |
Number of retired or separated participants receiving benefits | 2022-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
Total of all active and inactive participants | 2022-07-01 | 116 |
2021: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-07-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 103 |
Number of retired or separated participants receiving benefits | 2021-07-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
Total of all active and inactive participants | 2021-07-01 | 105 |
2020: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-07-01 | 104 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 100 |
Number of retired or separated participants receiving benefits | 2020-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2020-07-01 | 0 |
Total of all active and inactive participants | 2020-07-01 | 101 |
2019: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-07-01 | 106 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 104 |
Number of retired or separated participants receiving benefits | 2019-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2019-07-01 | 0 |
Total of all active and inactive participants | 2019-07-01 | 105 |
2018: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-07-01 | 106 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 104 |
Number of retired or separated participants receiving benefits | 2018-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
Total of all active and inactive participants | 2018-07-01 | 105 |
2017: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-07-01 | 105 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 108 |
Number of retired or separated participants receiving benefits | 2017-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 4 |
Total of all active and inactive participants | 2017-07-01 | 113 |
2016: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-07-01 | 113 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 111 |
Number of retired or separated participants receiving benefits | 2016-07-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
Total of all active and inactive participants | 2016-07-01 | 113 |
2015: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-07-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 113 |
Number of retired or separated participants receiving benefits | 2015-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 0 |
Total of all active and inactive participants | 2015-07-01 | 114 |
2014: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-07-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 111 |
Number of retired or separated participants receiving benefits | 2014-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 1 |
Total of all active and inactive participants | 2014-07-01 | 113 |
2013: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-07-01 | 117 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 108 |
Total of all active and inactive participants | 2013-07-01 | 108 |
2012: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-07-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 117 |
Total of all active and inactive participants | 2012-07-01 | 117 |
2011: OREGON HEALTH & SCIENCE UNIVERSITY FOUNDATION WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-07-01 | 109 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 115 |
Total of all active and inactive participants | 2011-07-01 | 115 |
CASCADE CENTERS INC. (National Association of Insurance Commissioners NAIC id number: 62133 ) |
Policy contract number | |
Policy instance | 8 |
Number of Individuals Covered | 110 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2022-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $1,089 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 112 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,861 | Temporary Disability 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 $1,861 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 112 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,302 | Long Term Disability 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 $3,302 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 112 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,518 | Life 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 $1,518 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 4 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 32 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,880 | Total amount of fees paid to insurance company | USD $104 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $154,498 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,880 | Amount paid for insurance broker fees | 104 | Additional information about fees paid to insurance broker | NON-MONETARY COMP/BONUS | Insurance broker organization code? | 3 |
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MODA HEALTH (National Association of Insurance Commissioners NAIC id number: 47098 ) |
Policy contract number | 10010287 |
Policy instance | 5 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 166 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $35,909 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $866,645 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,909 | Insurance broker organization code? | 3 |
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OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) |
Policy contract number | 10010287 |
Policy instance | 6 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 166 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,082 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,258 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,082 | Insurance broker organization code? | 3 |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | J4J68 |
Policy instance | 7 |
Insurance contract or identification number | J4J68 | Number of Individuals Covered | 9 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $663 | Other welfare benefits provided | SUPPLEMENTAL HEALTH/LIFE/DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $3,958 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $400 | Additional information about fees paid to insurance broker | ADMIN | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 103 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $2,228 | Life 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 $2,228 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 103 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $4,475 | Long Term Disability 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 $4,475 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 103 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $2,724 | Temporary Disability 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 $2,724 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 4 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 26 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $6,652 | Total amount of fees paid to insurance company | USD $102 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $222,195 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,652 | Amount paid for insurance broker fees | 102 | Additional information about fees paid to insurance broker | NON-MONETARY COMP/BONUS | Insurance broker organization code? | 3 |
|
MODA HEALTH (National Association of Insurance Commissioners NAIC id number: 47098 ) |
Policy contract number | 10010287 |
Policy instance | 5 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 163 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $84,565 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,691,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $84,565 | Insurance broker organization code? | 3 |
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OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) |
Policy contract number | 10010287 |
Policy instance | 6 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 163 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $4,994 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $99,877 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,994 | Insurance broker organization code? | 3 |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | J4J68 |
Policy instance | 7 |
Insurance contract or identification number | J4J68 | Number of Individuals Covered | 9 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $734 | Other welfare benefits provided | SUPPLEMENTAL HEALTH/LIFE/DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $8,198 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $387 | Additional information about fees paid to insurance broker | ADMIN | Insurance broker organization code? | 3 |
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CASCADE CENTERS INC. (National Association of Insurance Commissioners NAIC id number: 62133 ) |
Policy contract number | |
Policy instance | 8 |
Number of Individuals Covered | 110 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $1,955 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 100 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $2,221 | Life 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 $2,221 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 100 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $4,446 | Long Term Disability 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 $4,446 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 100 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $2,706 | Temporary Disability 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 $2,706 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 4 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 27 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $6,927 | Total amount of fees paid to insurance company | USD $140 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $234,209 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,927 | Amount paid for insurance broker fees | 140 | Additional information about fees paid to insurance broker | NON-MONETARY COMP/BONUS | Insurance broker organization code? | 3 |
|
MODA HEALTH (National Association of Insurance Commissioners NAIC id number: 47098 ) |
Policy contract number | 10010287 |
Policy instance | 5 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 170 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $82,804 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,650,850 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $82,804 | Insurance broker organization code? | 3 |
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OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) |
Policy contract number | 10010287 |
Policy instance | 6 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 170 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $5,084 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $101,358 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,084 | Insurance broker organization code? | 3 |
|
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | J4J68 |
Policy instance | 7 |
Insurance contract or identification number | J4J68 | Number of Individuals Covered | 11 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $1,196 | Total amount of fees paid to insurance company | USD $73 | Other welfare benefits provided | SUPPLEMENTAL HEALTH/LIFE/DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $13,157 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $740 | Amount paid for insurance broker fees | 61 | Additional information about fees paid to insurance broker | ADMIN | Insurance broker organization code? | 3 |
|
CASCADE CENTERS INC. (National Association of Insurance Commissioners NAIC id number: 62133 ) |
Policy contract number | |
Policy instance | 8 |
Number of Individuals Covered | 83 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $1,643 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | J4J68 |
Policy instance | 7 |
Insurance contract or identification number | J4J68 | Number of Individuals Covered | 13 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $2,912 | Total amount of fees paid to insurance company | USD $231 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,254 | Amount paid for insurance broker fees | 133 | Additional information about fees paid to insurance broker | ADMIN | Insurance broker organization code? | 3 |
|
OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) |
Policy contract number | 10010287 |
Policy instance | 6 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 178 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $4,905 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $98,423 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,905 | Insurance broker organization code? | 3 |
|
MODA HEALTH (National Association of Insurance Commissioners NAIC id number: 47098 ) |
Policy contract number | 10010287 |
Policy instance | 5 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 178 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $77,990 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,565,019 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $77,990 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 105 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $3,247 | Life 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 $3,247 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 105 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $6,118 | Long Term Disability 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 $6,118 | Insurance broker organization code? | 3 |
|
CASCADE CENTERS INC. (National Association of Insurance Commissioners NAIC id number: 62133 ) |
Policy contract number | |
Policy instance | 8 |
Number of Individuals Covered | 83 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $1,643 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 4 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 24 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $5,987 | Total amount of fees paid to insurance company | USD $269 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $198,595 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,987 | Amount paid for insurance broker fees | 269 | Additional information about fees paid to insurance broker | NON-MONETARY COMP/BONUS | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 105 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $3,631 | Temporary Disability 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 $3,631 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 100 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $3,127 | Life 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 $2,672 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 100 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $3,486 | Temporary Disability 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 $3,065 | Insurance broker organization code? | 3 |
|
MODA HEALTH (National Association of Insurance Commissioners NAIC id number: 47098 ) |
Policy contract number | 10010287 |
Policy instance | 5 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 159 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $68,354 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,367,086 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $68,354 | Insurance broker organization code? | 3 |
|
OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) |
Policy contract number | 10010287 |
Policy instance | 6 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 159 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $4,679 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $93,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,679 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 100 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $6,011 | Long Term Disability 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 $5,326 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 4 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 28 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $5,718 | Total amount of fees paid to insurance company | USD $2 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $206,630 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,718 | Amount paid for insurance broker fees | 2 | Additional information about fees paid to insurance broker | NON-MONETARY COMP | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 103 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $2,742 | Life 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 $2,742 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 103 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $5,507 | Long Term Disability 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 $5,507 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 103 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $3,099 | Temporary Disability 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 $3,099 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 4 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 29 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $7,347 | Total amount of fees paid to insurance company | USD $162 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $224,432 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,347 | Amount paid for insurance broker fees | 162 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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MODA HEALTH (National Association of Insurance Commissioners NAIC id number: 47098 ) |
Policy contract number | 10010287 |
Policy instance | 5 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 167 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $61,407 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,237,875 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $61,407 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) |
Policy contract number | 10010287 |
Policy instance | 6 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 167 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $4,103 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $82,703 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,103 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 113 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $2,706 | Life 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 $2,706 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 112 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $3,608 | Temporary Disability 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 $3,608 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 4 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 33 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $6,581 | Total amount of fees paid to insurance company | USD $81 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $219,362 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,581 | Amount paid for insurance broker fees | 81 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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MODA HEALTH (National Association of Insurance Commissioners NAIC id number: 47098 ) |
Policy contract number | 10010287 |
Policy instance | 5 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 177 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $76,745 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,340,790 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $76,745 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) |
Policy contract number | 10010287 |
Policy instance | 6 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 177 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $5,269 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $92,052 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,269 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 113 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $5,148 | Long Term Disability 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 $5,148 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 113 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $2,285 | Life 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 $2,285 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 113 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $4,616 | Long Term Disability 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 $4,616 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 113 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $2,419 | Temporary Disability 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 $2,419 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 4 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 32 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $7,454 | Total amount of fees paid to insurance company | USD $169 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $248,468 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,454 | Amount paid for insurance broker fees | 169 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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MODA HEALTH (National Association of Insurance Commissioners NAIC id number: 47098 ) |
Policy contract number | 10010287 |
Policy instance | 5 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 175 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $59,947 | 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 $59,947 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) |
Policy contract number | 10010287 |
Policy instance | 6 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 175 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $4,224 | Dental 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 $4,224 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 108 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $2,418 | Temporary Disability 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 $2,418 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 108 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $4,616 | Long Term Disability 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 $4,616 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 4 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 33 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $6,330 | Total amount of fees paid to insurance company | USD $134 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $257,290 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,330 | Amount paid for insurance broker fees | 134 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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MODA HEALTH (National Association of Insurance Commissioners NAIC id number: 47098 ) |
Policy contract number | 10010287 |
Policy instance | 5 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 90 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $61,031 | 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 $61,031 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) |
Policy contract number | 10010287 |
Policy instance | 6 |
Insurance contract or identification number | 10010287 | Number of Individuals Covered | 90 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $4,452 | Dental 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 $4,452 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 108 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $2,283 | Life 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 $2,283 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | |
Policy instance | 4 |
Number of Individuals Covered | 97 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $69,078 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,381,572 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $64,881 | Insurance broker organization code? | 3 | Insurance broker name | ROSENBAUM FINANCIAL LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 117 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $2,385 | Temporary Disability 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 $907 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 117 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $4,605 | Long Term Disability 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 $2,119 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING, LLC |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 5 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 32 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $5,576 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $238,595 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,066 | Insurance broker organization code? | 3 | Insurance broker name | ROSENBAUM FINANCIAL LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 117 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $2,266 | Life 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 $929 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
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HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | |
Policy instance | 4 |
Number of Individuals Covered | 91 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $60,425 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,208,494 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 2 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 115 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $4,559 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,934 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 3 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 115 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $2,283 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,073 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 7111 |
Policy instance | 5 |
Insurance contract or identification number | 7111 | Number of Individuals Covered | 115 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $5,949 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $242,502 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 606400 |
Policy instance | 1 |
Insurance contract or identification number | 606400 | Number of Individuals Covered | 115 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $2,167 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $42,946 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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