LEGACY HEALTH has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED
401k plan membership statisitcs for LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED
| Measure | Date | Value |
|---|
| 2022: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 12,254 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 12,903 |
| Total of all active and inactive participants | 2022-01-01 | 12,903 |
| Total participants | 2022-01-01 | 12,903 |
| 2021: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 12,200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 12,254 |
| Total of all active and inactive participants | 2021-01-01 | 12,254 |
| Total participants | 2021-01-01 | 12,254 |
| 2020: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 12,230 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 12,200 |
| Total of all active and inactive participants | 2020-01-01 | 12,200 |
| Total participants | 2020-01-01 | 12,200 |
| 2019: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 12,298 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 12,230 |
| Total of all active and inactive participants | 2019-01-01 | 12,230 |
| Total participants | 2019-01-01 | 12,230 |
| 2018: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 12,146 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 12,298 |
| Total of all active and inactive participants | 2018-01-01 | 12,298 |
| Total participants | 2018-01-01 | 12,298 |
| 2017: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 11,549 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 12,146 |
| Total of all active and inactive participants | 2017-01-01 | 12,146 |
| Total participants | 2017-01-01 | 12,146 |
| 2016: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 9,937 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 10,545 |
| Total of all active and inactive participants | 2016-01-01 | 10,545 |
| Total participants | 2016-01-01 | 10,545 |
| 2015: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 9,278 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 9,901 |
| Total of all active and inactive participants | 2015-01-01 | 9,901 |
| Total participants | 2015-01-01 | 0 |
| 2014: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 8,863 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 9,220 |
| Total of all active and inactive participants | 2014-01-01 | 9,220 |
| Total participants | 2014-01-01 | 0 |
| 2013: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 8,363 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 8,771 |
| Total of all active and inactive participants | 2013-01-01 | 8,771 |
| Total participants | 2013-01-01 | 0 |
| 2012: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 8,414 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 8,363 |
| Total of all active and inactive participants | 2012-01-01 | 8,363 |
| Total participants | 2012-01-01 | 0 |
| 2011: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 8,400 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 8,414 |
| Total of all active and inactive participants | 2011-01-01 | 8,414 |
| Total participants | 2011-01-01 | 8,414 |
| 2009: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 8,254 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 8,358 |
| Total of all active and inactive participants | 2009-01-01 | 8,358 |
| Total participants | 2009-01-01 | 8,358 |
| 2022: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: LEGACY HEALTH SYSTEM WELFARE BENEFITS PLAN UNFUNDED 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | LBT |
| Policy instance | 5 |
| Insurance contract or identification number | LBT | | Number of Individuals Covered | 1609 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $881,463 | | Other welfare benefits provided | LONG TERM CARE & LIFE INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $1,273,339 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $303,901 | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000025867 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000025867 | | Number of Individuals Covered | 5519 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $504,476 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,163,622 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $336,619 |
|
| HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 ) |
| Policy contract number | GTA101277 |
| Policy instance | 3 |
| Insurance contract or identification number | GTA101277 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $18,883 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | ADDS07955 |
| Policy instance | 2 |
| Insurance contract or identification number | ADDS07955 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $9,056 | | Total amount of fees paid to insurance company | USD $5,764 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $393,926 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,056 | | Amount paid for insurance broker fees | 5764 | | 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 | 675851-0GL |
| Policy instance | 1 |
| Insurance contract or identification number | 675851-0GL | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $124,199 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,640,472 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $124,199 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 675851-0GL |
| Policy instance | 1 |
| Insurance contract or identification number | 675851-0GL | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $106,452 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,138,416 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $106,452 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | ADDS07955 |
| Policy instance | 2 |
| Insurance contract or identification number | ADDS07955 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $11,363 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $417,638 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,363 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 ) |
| Policy contract number | GTA101277 |
| Policy instance | 3 |
| Insurance contract or identification number | GTA101277 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000025867 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000025867 | | Number of Individuals Covered | 5315 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $516,846 | | Welfare Benefit Premiums Paid to Carrier | USD $1,955,562 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $486,190 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | LBT |
| Policy instance | 5 |
| Insurance contract or identification number | LBT | | Number of Individuals Covered | 1743 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $162,144 | | Welfare Benefit Premiums Paid to Carrier | USD $321,698 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $57,909 | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000025867 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000025867 | | Number of Individuals Covered | 5571 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $380,355 | | Welfare Benefit Premiums Paid to Carrier | USD $1,668,129 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $380,355 |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GTA101277 |
| Policy instance | 3 |
| Insurance contract or identification number | GTA101277 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $6,893 | | Total amount of fees paid to insurance company | USD $7,812 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $45,950 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 7812 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $6,893 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | ADDS07955 |
| Policy instance | 2 |
| Insurance contract or identification number | ADDS07955 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $11,870 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $430,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,870 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 675851-0GL |
| Policy instance | 1 |
| Insurance contract or identification number | 675851-0GL | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $100,327 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,836,994 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $100,327 | | 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 | 675851-0GL |
| Policy instance | 1 |
| Insurance contract or identification number | 675851-0GL | | Number of Individuals Covered | 12230 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $94,691 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,765,147 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $94,691 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | ADDS07955 |
| Policy instance | 2 |
| Insurance contract or identification number | ADDS07955 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $10,847 | | Total amount of fees paid to insurance company | USD $2,390 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $474,369 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,847 | | Amount paid for insurance broker fees | 2390 | | 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 | ETB114035 |
| Policy instance | 3 |
| Insurance contract or identification number | ETB114035 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $8,750 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 675851-0GL |
| Policy instance | 1 |
| Insurance contract or identification number | 675851-0GL | | Number of Individuals Covered | 12298 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $102,644 | | Total amount of fees paid to insurance company | USD $22,068 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,784,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $102,644 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 22068 | | Additional information about fees paid to insurance broker | BONUS |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | ADDS07955 |
| Policy instance | 2 |
| Insurance contract or identification number | ADDS07955 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $12,832 | | Total amount of fees paid to insurance company | USD $2,244 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $484,265 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,832 | | Amount paid for insurance broker fees | 2244 | | 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 | ETB114035 |
| Policy instance | 3 |
| Insurance contract or identification number | ETB114035 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,100 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | ETB114035 |
| Policy instance | 3 |
| Insurance contract or identification number | ETB114035 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $4,375 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | HARTFORD HOME OFFICE DIRECT |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | ADDS07955 |
| Policy instance | 2 |
| Insurance contract or identification number | ADDS07955 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $10,380 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $460,211 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,380 | | Insurance broker name | WOODRUFF-SAWYER OREGON INC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 675851-0GL |
| Policy instance | 1 |
| Insurance contract or identification number | 675851-0GL | | Number of Individuals Covered | 12146 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $79,310 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,756,142 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $79,310 | | Insurance broker organization code? | 3 | | Insurance broker name | WOODRUFF- SAWYER OREGON INC |
|
