ROBINDALE ENERGY SERVICES, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN
401k plan membership statisitcs for ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN
| Measure | Date | Value |
|---|
| 2022: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 640 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 745 |
| Total of all active and inactive participants | 2022-01-01 | 745 |
| 2021: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 601 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 557 |
| Total of all active and inactive participants | 2021-01-01 | 557 |
| 2020: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 613 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 601 |
| Total of all active and inactive participants | 2020-01-01 | 601 |
| 2019: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 588 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 622 |
| Total of all active and inactive participants | 2019-01-01 | 622 |
| 2018: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 402 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 588 |
| Total of all active and inactive participants | 2018-01-01 | 588 |
| 2017: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 332 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 402 |
| Total of all active and inactive participants | 2017-01-01 | 402 |
| 2016: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 236 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 332 |
| Total of all active and inactive participants | 2016-01-01 | 332 |
| 2015: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 468 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 236 |
| Total of all active and inactive participants | 2015-01-01 | 236 |
| 2014: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 403 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 468 |
| Total of all active and inactive participants | 2014-01-01 | 468 |
| 2013: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 274 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 402 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 1 |
| Total of all active and inactive participants | 2013-01-01 | 403 |
| 2012: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 239 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 270 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 4 |
| Total of all active and inactive participants | 2012-01-01 | 274 |
| 2011: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 230 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 9 |
| Total of all active and inactive participants | 2011-01-01 | 239 |
| 2010: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 135 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 3 |
| Total of all active and inactive participants | 2010-01-01 | 138 |
| 2022: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan is a collectively bargained plan | Yes |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | Yes |
| 2021-01-01 | Plan is a collectively bargained plan | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan is a collectively bargained plan | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan is a collectively bargained plan | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan is a collectively bargained plan | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan is a collectively bargained plan | Yes |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan is a collectively bargained plan | Yes |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan is a collectively bargained plan | Yes |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan is a collectively bargained plan | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan is a collectively bargained plan | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 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: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Mulitple employer plan |
| 2012-01-01 | Plan is a collectively bargained plan | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Mulitple employer plan |
| 2011-01-01 | Plan is a collectively bargained plan | Yes |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: ROBINDALE ENERGY SERVICES, INC. HEALTH INSURANCE PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | First time form 5500 has been submitted | Yes |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 153389 |
| Policy instance | 4 |
| Insurance contract or identification number | 153389 | | Number of Individuals Covered | 103 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $829 | | Total amount of fees paid to insurance company | USD $0 | | 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 $507 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 926823 |
| Policy instance | 3 |
| Insurance contract or identification number | 926823 | | Number of Individuals Covered | 643 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 153389 |
| Policy instance | 2 |
| Insurance contract or identification number | 153389 | | Number of Individuals Covered | 104 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $4,221 | | Total amount of fees paid to insurance company | USD $0 | | 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 $2,577 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 612 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $115,056 | | Total amount of fees paid to insurance company | USD $0 | | 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 $115,056 | | Insurance broker organization code? | 3 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 574 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $116,244 | | Total amount of fees paid to insurance company | USD $0 | | 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 $116,244 | | Insurance broker organization code? | 3 |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00522413 |
| Policy instance | 2 |
| Insurance contract or identification number | 00522413 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 153389 |
| Policy instance | 3 |
| Insurance contract or identification number | 153389 | | Number of Individuals Covered | 93 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $4,020 | | Total amount of fees paid to insurance company | USD $0 | | 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 $2,381 |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5482841 |
| Policy instance | 4 |
| Insurance contract or identification number | 5482841 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 926823 |
| Policy instance | 5 |
| Insurance contract or identification number | 926823 | | Number of Individuals Covered | 1094 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 153389 |
| Policy instance | 6 |
| Insurance contract or identification number | 153389 | | Number of Individuals Covered | 91 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $852 | | Total amount of fees paid to insurance company | USD $0 | | 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 $693 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 500 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $109,710 | | Total amount of fees paid to insurance company | USD $0 | | 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 $109,710 | | Insurance broker organization code? | 3 |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00522413 |
| Policy instance | 2 |
| Insurance contract or identification number | 00522413 | | Number of Individuals Covered | 96 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $468 | | Total amount of fees paid to insurance company | USD $0 | | 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 $468 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 153389 |
| Policy instance | 3 |
| Insurance contract or identification number | 153389 | | Number of Individuals Covered | 94 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $4,573 | | Total amount of fees paid to insurance company | USD $0 | | 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 $2,744 | | Insurance broker organization code? | 3 |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5482841 |
| Policy instance | 4 |
| Insurance contract or identification number | 5482841 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 926823 |
| Policy instance | 5 |
| Insurance contract or identification number | 926823 | | Number of Individuals Covered | 476 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 926823 |
| Policy instance | 6 |
| Insurance contract or identification number | 926823 | | Number of Individuals Covered | 544 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5482841 |
| Policy instance | 5 |
| Insurance contract or identification number | 5482841 | | Number of Individuals Covered | 519 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 153389 |
| Policy instance | 4 |
| Insurance contract or identification number | 153389 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00522413 |
| Policy instance | 3 |
| Insurance contract or identification number | 00522413 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $475 | | Total amount of fees paid to insurance company | USD $0 | | 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 $475 |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00522413 |
| Policy instance | 2 |
| Insurance contract or identification number | 00522413 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 545 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $119,628 | | Total amount of fees paid to insurance company | USD $0 | | 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 $119,628 | | Insurance broker organization code? | 3 |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5482841 |
| Policy instance | 5 |
| Insurance contract or identification number | 5482841 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 153389 |
| Policy instance | 4 |
| Insurance contract or identification number | 153389 | | Number of Individuals Covered | 92 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,310 | | Total amount of fees paid to insurance company | USD $0 | | 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 $1,828 |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00522413 |
| Policy instance | 3 |
| Insurance contract or identification number | 00522413 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00522413 |
| Policy instance | 2 |
| Insurance contract or identification number | 00522413 | | Number of Individuals Covered | 87 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $443 | | Total amount of fees paid to insurance company | USD $0 | | 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 $443 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 | | Insurance broker organization code? | 3 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 393 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 | | Insurance broker organization code? | 3 | | Insurance broker name | TENTH DOT BENEFITS SOLUTIONS LLC |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00522413 |
| Policy instance | 2 |
| Insurance contract or identification number | 00522413 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $239 | | Total amount of fees paid to insurance company | USD $0 | | Dental 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 $239 | | Insurance broker name | EMBROOK BENEFITS CONSULTING |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00522413 |
| Policy instance | 3 |
| Insurance contract or identification number | 00522413 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $193 | | Total amount of fees paid to insurance company | USD $0 | | 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 $193 | | Insurance broker name | EMBROOK BENEFITS CONSULTING |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 153389 |
| Policy instance | 4 |
| Insurance contract or identification number | 153389 | | Number of Individuals Covered | 82 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $649 | | Total amount of fees paid to insurance company | USD $0 | | 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 $649 | | Insurance broker name | EMBROOK BENEFITS CONSULTING |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5482841 |
| Policy instance | 5 |
| Insurance contract or identification number | 5482841 | | Number of Individuals Covered | 383 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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 | ANTHONY PERRICELLI |
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| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00522413 |
| Policy instance | 2 |
| Insurance contract or identification number | 00522413 | | Number of Individuals Covered | 68 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $5,593 | | Total amount of fees paid to insurance company | USD $0 | | Dental 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 $5,593 | | Insurance broker organization code? | 3 | | Insurance broker name | EMBROOK BENEFITS CONSULTING, LLC |
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| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 342 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 | | Insurance broker organization code? | 3 | | Insurance broker name | TENTH DOT BENEFITS SOLUTIONS LLC |
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| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 374 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $2,555 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $1,553 | | Insurance broker organization code? | 3 | | Insurance broker name | THE BENECON GROUP |
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| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
| Policy contract number | 836796 |
| Policy instance | 2 |
| Insurance contract or identification number | 836796 | | Number of Individuals Covered | 303 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $8,515 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $6,115 | | Insurance broker organization code? | 3 | | Insurance broker name | M & T INSURANCE AGENCY |
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| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
| Policy contract number | 836796 |
| Policy instance | 2 |
| Insurance contract or identification number | 836796 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $7,322 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $7,322 | | Insurance broker organization code? | 3 | | Insurance broker name | M & T INSURANCE AGENCY |
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| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 390 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $50,599 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $50,599 | | Insurance broker organization code? | 3 | | Insurance broker name | THE BENECON GROUP |
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| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 245 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $103,417 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $60,408 | | Insurance broker organization code? | 3 | | Insurance broker name | S&T - EVERGREEN INSURANCE LLC |
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| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 201 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $60,972 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 |
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| HIGHMARK (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 009359 |
| Policy instance | 1 |
| Insurance contract or identification number | 009359 | | Number of Individuals Covered | 120 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $54,039 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 |
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