WYNMOOR COMMUNITY COUNCIL, INC. has sponsored the creation of one or more 401k plans.
Additional information about WYNMOOR COMMUNITY COUNCIL, INC.
Submission information for form 5500 for 401k plan WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01
401k plan membership statisitcs for WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01
| Measure | Date | Value |
|---|
| 2022: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-10-01 | 158 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-01 | 166 |
| Number of retired or separated participants receiving benefits | 2022-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-10-01 | 0 |
| Total of all active and inactive participants | 2022-10-01 | 166 |
| Number of employers contributing to the scheme | 2022-10-01 | 0 |
| 2021: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 158 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 158 |
| Number of employers contributing to the scheme | 2021-10-01 | 0 |
| 2020: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-10-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 142 |
| Number of retired or separated participants receiving benefits | 2020-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-10-01 | 0 |
| Total of all active and inactive participants | 2020-10-01 | 142 |
| Number of employers contributing to the scheme | 2020-10-01 | 0 |
| 2019: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-10-01 | 165 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 127 |
| Number of retired or separated participants receiving benefits | 2019-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-10-01 | 0 |
| Total of all active and inactive participants | 2019-10-01 | 127 |
| Number of employers contributing to the scheme | 2019-10-01 | 0 |
| 2018: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-10-01 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 165 |
| Number of retired or separated participants receiving benefits | 2018-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-10-01 | 0 |
| Total of all active and inactive participants | 2018-10-01 | 165 |
| Number of employers contributing to the scheme | 2018-10-01 | 0 |
| 2017: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 161 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 168 |
| Number of retired or separated participants receiving benefits | 2017-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
| Total of all active and inactive participants | 2017-10-01 | 168 |
| Number of employers contributing to the scheme | 2017-10-01 | 0 |
| 2016: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 161 |
| Number of retired or separated participants receiving benefits | 2016-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-10-01 | 0 |
| Total of all active and inactive participants | 2016-10-01 | 161 |
| Total participants, beginning-of-year | 2016-05-01 | 136 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 129 |
| Number of retired or separated participants receiving benefits | 2016-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-05-01 | 0 |
| Total of all active and inactive participants | 2016-05-01 | 129 |
| 2015: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 167 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 136 |
| Number of retired or separated participants receiving benefits | 2015-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-05-01 | 0 |
| Total of all active and inactive participants | 2015-05-01 | 136 |
| 2014: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 158 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 167 |
| Number of retired or separated participants receiving benefits | 2014-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-05-01 | 0 |
| Total of all active and inactive participants | 2014-05-01 | 167 |
| 2013: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 157 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 158 |
| Number of retired or separated participants receiving benefits | 2013-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-05-01 | 0 |
| Total of all active and inactive participants | 2013-05-01 | 158 |
| 2012: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 169 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 157 |
| Number of retired or separated participants receiving benefits | 2012-05-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2012-05-01 | 0 |
| Total of all active and inactive participants | 2012-05-01 | 158 |
| 2011: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-05-01 | 164 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 168 |
| Number of retired or separated participants receiving benefits | 2011-05-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2011-05-01 | 0 |
| Total of all active and inactive participants | 2011-05-01 | 169 |
| 2009: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-05-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 132 |
| Number of retired or separated participants receiving benefits | 2009-05-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2009-05-01 | 0 |
| Total of all active and inactive participants | 2009-05-01 | 133 |
| 2007: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-05-01 | 137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-05-01 | 159 |
| Number of retired or separated participants receiving benefits | 2007-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-05-01 | 0 |
| Total of all active and inactive participants | 2007-05-01 | 159 |
| 2006: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-05-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-05-01 | 137 |
| Number of retired or separated participants receiving benefits | 2006-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2006-05-01 | 0 |
| Total of all active and inactive participants | 2006-05-01 | 137 |
| 2005: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-05-01 | 99 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-05-01 | 104 |
| Number of retired or separated participants receiving benefits | 2005-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2005-05-01 | 0 |
| Total of all active and inactive participants | 2005-05-01 | 104 |
| 2004: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-05-01 | 113 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-05-01 | 99 |
| Number of retired or separated participants receiving benefits | 2004-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2004-05-01 | 0 |
| Total of all active and inactive participants | 2004-05-01 | 99 |
| 2003: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2003 401k membership |
|---|
| Total participants, beginning-of-year | 2003-05-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-05-01 | 113 |
| Number of retired or separated participants receiving benefits | 2003-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2003-05-01 | 0 |
| Total of all active and inactive participants | 2003-05-01 | 113 |
| 2002: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2002 401k membership |
|---|
| Total participants, beginning-of-year | 2002-05-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2002-05-01 | 117 |
| Number of retired or separated participants receiving benefits | 2002-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2002-05-01 | 0 |
| Total of all active and inactive participants | 2002-05-01 | 117 |
| 2001: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2001 401k membership |
|---|
| Total participants, beginning-of-year | 2001-05-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2001-05-01 | 126 |
| Number of retired or separated participants receiving benefits | 2001-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2001-05-01 | 0 |
| Total of all active and inactive participants | 2001-05-01 | 126 |
| 2000: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2000 401k membership |
|---|
| Total participants, beginning-of-year | 2000-05-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2000-05-01 | 124 |
| Number of retired or separated participants receiving benefits | 2000-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2000-05-01 | 0 |
| Total of all active and inactive participants | 2000-05-01 | 124 |
| 2022: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2022 form 5500 responses |
|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2020 form 5500 responses |
|---|
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2019 form 5500 responses |
|---|
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2018 form 5500 responses |
|---|
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Submission has been amended | No |
| 2016-10-01 | This submission is the final filing | No |
| 2016-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-10-01 | Plan is a collectively bargained plan | No |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-05-01 | Type of plan entity | Single employer plan |
| 2016-05-01 | Submission has been amended | No |
| 2016-05-01 | This submission is the final filing | No |
| 2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2016-05-01 | Plan is a collectively bargained plan | No |
| 2016-05-01 | Plan funding arrangement – Insurance | Yes |
| 2016-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2015 form 5500 responses |
|---|
| 2015-05-01 | Type of plan entity | Single employer plan |
| 2015-05-01 | Submission has been amended | No |
| 2015-05-01 | This submission is the final filing | No |
| 2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-05-01 | Plan is a collectively bargained plan | No |
| 2015-05-01 | Plan funding arrangement – Insurance | Yes |
| 2015-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2014 form 5500 responses |
|---|
| 2014-05-01 | Type of plan entity | Single employer plan |
| 2014-05-01 | Submission has been amended | No |
| 2014-05-01 | This submission is the final filing | No |
| 2014-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-05-01 | Plan is a collectively bargained plan | No |
| 2014-05-01 | Plan funding arrangement – Insurance | Yes |
| 2014-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2013 form 5500 responses |
|---|
| 2013-05-01 | Type of plan entity | Single employer plan |
| 2013-05-01 | Submission has been amended | No |
| 2013-05-01 | This submission is the final filing | No |
| 2013-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-05-01 | Plan is a collectively bargained plan | No |
| 2013-05-01 | Plan funding arrangement – Insurance | Yes |
| 2013-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2012 form 5500 responses |
|---|
| 2012-05-01 | Type of plan entity | Single employer plan |
| 2012-05-01 | Submission has been amended | No |
| 2012-05-01 | This submission is the final filing | No |
| 2012-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-05-01 | Plan is a collectively bargained plan | No |
| 2012-05-01 | Plan funding arrangement – Insurance | Yes |
| 2012-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2011 form 5500 responses |
|---|
| 2011-05-01 | Type of plan entity | Single employer plan |
| 2011-05-01 | Submission has been amended | No |
| 2011-05-01 | This submission is the final filing | No |
| 2011-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-05-01 | Plan is a collectively bargained plan | No |
| 2011-05-01 | Plan funding arrangement – Insurance | Yes |
| 2011-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2009 form 5500 responses |
|---|
| 2009-05-01 | Type of plan entity | Single employer plan |
| 2009-05-01 | Submission has been amended | No |
| 2009-05-01 | This submission is the final filing | No |
| 2009-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-05-01 | Plan is a collectively bargained plan | No |
| 2009-05-01 | Plan funding arrangement – Insurance | Yes |
| 2009-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2007 form 5500 responses |
|---|
| 2007-05-01 | Type of plan entity | Single employer plan |
| 2007-05-01 | Submission has been amended | No |
| 2007-05-01 | This submission is the final filing | No |
| 2007-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-05-01 | Plan is a collectively bargained plan | No |
| 2007-05-01 | Plan funding arrangement – Insurance | Yes |
| 2007-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2006 form 5500 responses |
|---|
| 2006-05-01 | Type of plan entity | Single employer plan |
| 2006-05-01 | Submission has been amended | No |
| 2006-05-01 | This submission is the final filing | No |
| 2006-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-05-01 | Plan is a collectively bargained plan | No |
| 2006-05-01 | Plan funding arrangement – Insurance | Yes |
| 2006-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2005 form 5500 responses |
|---|
| 2005-05-01 | Type of plan entity | Single employer plan |
| 2005-05-01 | Submission has been amended | No |
| 2005-05-01 | This submission is the final filing | No |
| 2005-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-05-01 | Plan is a collectively bargained plan | No |
| 2005-05-01 | Plan funding arrangement – Insurance | Yes |
| 2005-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2004 form 5500 responses |
|---|
| 2004-05-01 | Type of plan entity | Single employer plan |
| 2004-05-01 | Submission has been amended | No |
| 2004-05-01 | This submission is the final filing | No |
| 2004-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2004-05-01 | Plan is a collectively bargained plan | No |
| 2004-05-01 | Plan funding arrangement – Insurance | Yes |
| 2004-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2003: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2003 form 5500 responses |
|---|
| 2003-05-01 | Type of plan entity | Single employer plan |
| 2003-05-01 | Submission has been amended | No |
| 2003-05-01 | This submission is the final filing | No |
| 2003-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2003-05-01 | Plan is a collectively bargained plan | No |
| 2003-05-01 | Plan funding arrangement – Insurance | Yes |
| 2003-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2002: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2002 form 5500 responses |
|---|
| 2002-05-01 | Type of plan entity | Single employer plan |
| 2002-05-01 | Submission has been amended | No |
| 2002-05-01 | This submission is the final filing | No |
| 2002-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2002-05-01 | Plan is a collectively bargained plan | No |
| 2002-05-01 | Plan funding arrangement – Insurance | Yes |
| 2002-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2001: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2001 form 5500 responses |
|---|
| 2001-05-01 | Type of plan entity | Single employer plan |
| 2001-05-01 | Submission has been amended | No |
| 2001-05-01 | This submission is the final filing | No |
| 2001-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2001-05-01 | Plan is a collectively bargained plan | No |
| 2001-05-01 | Plan funding arrangement – Insurance | Yes |
| 2001-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2000: WYNMOOR COMMUNITY COUNCIL, INC. HEALTH AND WELFARE PLAN 01 2000 form 5500 responses |
|---|
| 2000-05-01 | Type of plan entity | Single employer plan |
| 2000-05-01 | Submission has been amended | No |
| 2000-05-01 | This submission is the final filing | No |
| 2000-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2000-05-01 | Plan is a collectively bargained plan | No |
| 2000-05-01 | Plan funding arrangement – Insurance | Yes |
| 2000-05-01 | Plan benefit arrangement – Insurance | Yes |
| COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) |
| Policy contract number | 772472 |
| Policy instance | 5 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $597 | | Total amount of fees paid to insurance company | USD $1,077 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,480 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $597 | | Amount paid for insurance broker fees | 1077 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | 97405 |
| Policy instance | 4 |
| Insurance contract or identification number | 97405 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $3,066 | | Total amount of fees paid to insurance company | USD $296 | | Other welfare benefits provided | CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $26,179 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,837 | | Amount paid for insurance broker fees | 202 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 881976G |
| Policy instance | 3 |
| Insurance contract or identification number | 881976G | | Number of Individuals Covered | 161 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $11,512 | | Total amount of fees paid to insurance company | USD $3,016 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $78,449 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,512 | | Amount paid for insurance broker fees | 3016 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 772472 |
| Policy instance | 2 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $5,292 | | Total amount of fees paid to insurance company | USD $2,759 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,843 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,292 | | Amount paid for insurance broker fees | 2759 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | 772472 |
| Policy instance | 1 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $36,572 | | Total amount of fees paid to insurance company | USD $2,551 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $781,022 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,572 | | Amount paid for insurance broker fees | 2551 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | 772472 |
| Policy instance | 1 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $32,061 | | Total amount of fees paid to insurance company | USD $3,294 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $647,190 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,061 | | Amount paid for insurance broker fees | 3294 | | Additional information about fees paid to insurance broker | BONUS, NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 772472 |
| Policy instance | 2 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 86 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $4,749 | | Total amount of fees paid to insurance company | USD $1,308 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $47,671 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,749 | | Amount paid for insurance broker fees | 1308 | | Additional information about fees paid to insurance broker | BONUS, NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 881976G |
| Policy instance | 3 |
| Insurance contract or identification number | 881976G | | Number of Individuals Covered | 149 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $10,702 | | Total amount of fees paid to insurance company | USD $795 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $72,818 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,702 | | Amount paid for insurance broker fees | 795 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | 97405 |
| Policy instance | 4 |
| Insurance contract or identification number | 97405 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $5,130 | | Total amount of fees paid to insurance company | USD $24 | | Other welfare benefits provided | CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $24,531 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,577 | | Amount paid for insurance broker fees | 16 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) |
| Policy contract number | 772472 |
| Policy instance | 5 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $507 | | Total amount of fees paid to insurance company | USD $421 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,093 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $507 | | Amount paid for insurance broker fees | 421 | | Additional information about fees paid to insurance broker | BONUS, NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) |
| Policy contract number | 772472 |
| Policy instance | 5 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $597 | | Total amount of fees paid to insurance company | USD $567 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,012 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $597 | | Amount paid for insurance broker fees | 567 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | 97405 |
| Policy instance | 4 |
| Insurance contract or identification number | 97405 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $1,886 | | Total amount of fees paid to insurance company | USD $61 | | Other welfare benefits provided | CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $18,693 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $853 | | Amount paid for insurance broker fees | 50 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 881976G |
| Policy instance | 3 |
| Insurance contract or identification number | 881976G | | Number of Individuals Covered | 161 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $10,100 | | Total amount of fees paid to insurance company | USD $1,086 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $68,805 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,100 | | Amount paid for insurance broker fees | 1086 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 772472 |
| Policy instance | 2 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $5,566 | | Total amount of fees paid to insurance company | USD $2,156 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,077 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,566 | | Amount paid for insurance broker fees | 2156 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | 772472 |
| Policy instance | 1 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $34,303 | | Total amount of fees paid to insurance company | USD $2,748 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $689,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,303 | | Amount paid for insurance broker fees | 2748 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) |
| Policy contract number | 772472 |
| Policy instance | 5 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $639 | | Total amount of fees paid to insurance company | USD $726 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,506 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $639 | | Amount paid for insurance broker fees | 726 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | 97405 |
| Policy instance | 4 |
| Insurance contract or identification number | 97405 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $2,567 | | Total amount of fees paid to insurance company | USD $35 | | Other welfare benefits provided | CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $20,705 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,361 | | Amount paid for insurance broker fees | 25 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 881976G |
| Policy instance | 3 |
| Insurance contract or identification number | 881976G | | Number of Individuals Covered | 164 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $10,781 | | Total amount of fees paid to insurance company | USD $1,612 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $73,190 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,781 | | Amount paid for insurance broker fees | 1612 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 772472 |
| Policy instance | 2 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 86 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $5,400 | | Total amount of fees paid to insurance company | USD $1,898 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $54,130 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,400 | | Amount paid for insurance broker fees | 1898 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | 772472 |
| Policy instance | 1 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 95 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $37,572 | | Total amount of fees paid to insurance company | USD $2,536 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $751,435 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,572 | | Amount paid for insurance broker fees | 2536 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 772472 |
| Policy instance | 2 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $5,448 | | Total amount of fees paid to insurance company | USD $2,696 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,685 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,448 | | Amount paid for insurance broker fees | 2696 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 881976G |
| Policy instance | 3 |
| Insurance contract or identification number | 881976G | | Number of Individuals Covered | 167 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $11,724 | | Total amount of fees paid to insurance company | USD $316 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $79,697 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,724 | | Amount paid for insurance broker fees | 316 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | 97405 |
| Policy instance | 4 |
| Insurance contract or identification number | 97405 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $2,106 | | Total amount of fees paid to insurance company | USD $24 | | Other welfare benefits provided | CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $20,634 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $869 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | FEES |
|
| COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) |
| Policy contract number | 772472 |
| Policy instance | 5 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $718 | | Total amount of fees paid to insurance company | USD $1,136 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,249 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $718 | | Amount paid for insurance broker fees | 1136 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 912059 |
| Policy instance | 1 |
| Insurance contract or identification number | 912059 | | Number of Individuals Covered | 99 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $34,107 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $817,907 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 34107 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 912059 |
| Policy instance | 1 |
| Insurance contract or identification number | 912059 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $33,413 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $769,483 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 772472 |
| Policy instance | 2 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 97 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $5,296 | | Total amount of fees paid to insurance company | USD $1,562 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $52,910 | | 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 | 97405 |
| Policy instance | 4 |
| Insurance contract or identification number | 97405 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $1,958 | | Total amount of fees paid to insurance company | USD $16 | | Other welfare benefits provided | CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $19,229 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) |
| Policy contract number | 772472 |
| Policy instance | 5 |
| Insurance contract or identification number | 772472 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $806 | | Total amount of fees paid to insurance company | USD $807 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 881976G |
| Policy instance | 3 |
| Insurance contract or identification number | 881976G | | Number of Individuals Covered | 171 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $9,978 | | Total amount of fees paid to insurance company | USD $3,937 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $67,946 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
