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GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 401k Plan overview

Plan NameGOOSEHEAD INSURANCE VISION AND DENTAL PLAN
Plan identification number 502

GOOSEHEAD INSURANCE VISION AND DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

GOOSEHEAD INSURANCE AGENCY has sponsored the creation of one or more 401k plans.

Company Name:GOOSEHEAD INSURANCE AGENCY
Employer identification number (EIN):262637311
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GOOSEHEAD INSURANCE VISION AND DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-05-01DERICKA MARSHALL2023-11-20
5022021-05-01DERICKA MARSHALL2022-11-03
5022020-05-01DERICKA MARSHALL2022-02-03
5022019-05-01THAO NGUYEN2021-02-04
5022018-05-01SHANA R. CAPODAGLI2020-02-04
5022017-05-01
5022016-05-01SHANA HARTFORD

Plan Statistics for GOOSEHEAD INSURANCE VISION AND DENTAL PLAN

401k plan membership statisitcs for GOOSEHEAD INSURANCE VISION AND DENTAL PLAN

Measure Date Value
2022: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-011,366
Total number of active participants reported on line 7a of the Form 55002022-05-010
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-010
Number of employers contributing to the scheme2022-05-010
2021: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01972
Total number of active participants reported on line 7a of the Form 55002021-05-011,366
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-011,366
Number of employers contributing to the scheme2021-05-010
2020: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01613
Total number of active participants reported on line 7a of the Form 55002020-05-01972
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01972
Number of employers contributing to the scheme2020-05-010
2019: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01276
Total number of active participants reported on line 7a of the Form 55002019-05-01354
Number of retired or separated participants receiving benefits2019-05-011
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01355
Number of employers contributing to the scheme2019-05-010
2018: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01101
Total number of active participants reported on line 7a of the Form 55002018-05-01111
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01111
Number of employers contributing to the scheme2018-05-010
2017: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01149
Total number of active participants reported on line 7a of the Form 55002017-05-01184
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01184
Number of employers contributing to the scheme2017-05-010
2016: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01125
Total number of active participants reported on line 7a of the Form 55002016-05-01153
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01153

Form 5500 Responses for GOOSEHEAD INSURANCE VISION AND DENTAL PLAN

2022: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01This submission is the final filingYes
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – InsuranceYes
2021: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes
2020: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: GOOSEHEAD INSURANCE VISION AND DENTAL PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01First time form 5500 has been submittedYes
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number241260
Policy instance 1
Insurance contract or identification number241260
Number of Individuals Covered1385
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $26,108
Total amount of fees paid to insurance companyUSD $3,044
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,ACCIDENT,HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $233,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,416
Amount paid for insurance broker fees180
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number474626
Policy instance 2
Insurance contract or identification number474626
Number of Individuals Covered1366
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $15,048
Total amount of fees paid to insurance companyUSD $815
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $131,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,048
Amount paid for insurance broker fees815
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number917510
Policy instance 1
Insurance contract or identification number917510
Number of Individuals Covered1137
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $9,321
Total amount of fees paid to insurance companyUSD $169,631
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,214,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,321
Amount paid for insurance broker fees169631
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number474626
Policy instance 2
Insurance contract or identification number474626
Number of Individuals Covered972
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $11,788
Total amount of fees paid to insurance companyUSD $719
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $90,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,788
Amount paid for insurance broker fees719
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number917510
Policy instance 1
Insurance contract or identification number917510
Number of Individuals Covered592
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $7,763
Total amount of fees paid to insurance companyUSD $119,554
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,196,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,763
Amount paid for insurance broker fees119554
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number876650
Policy instance 2
Insurance contract or identification number876650
Number of Individuals Covered165
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $9,190
Total amount of fees paid to insurance companyUSD $440
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $58,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,190
Amount paid for insurance broker fees440
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number917510
Policy instance 1
Insurance contract or identification number917510
Number of Individuals Covered405
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $4,422
Total amount of fees paid to insurance companyUSD $68,655
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,835,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,422
Amount paid for insurance broker fees68655
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number876650
Policy instance 2
Insurance contract or identification number876650
Number of Individuals Covered110
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $4,067
Total amount of fees paid to insurance companyUSD $203
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,225
Amount paid for insurance broker fees111
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number561646
Policy instance 1
Insurance contract or identification number561646
Number of Individuals Covered245
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $5,344
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $144,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,435
Amount paid for insurance broker fees0
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number561646
Policy instance 2
Insurance contract or identification number561646
Number of Individuals Covered184
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $3,420
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number561646
Policy instance 1
Insurance contract or identification number561646
Number of Individuals Covered145
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $2,384
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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