STONERISE HEALTHCARE, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan STONERISE HEALTHCARE LLC MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2020: STONERISE HEALTHCARE LLC MEDICAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-05-01 | 1,379 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 1,342 |
| Number of retired or separated participants receiving benefits | 2020-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 0 |
| Total of all active and inactive participants | 2020-05-01 | 1,342 |
| 2019: STONERISE HEALTHCARE LLC MEDICAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-05-01 | 1,478 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 1,330 |
| Number of retired or separated participants receiving benefits | 2019-05-01 | 24 |
| Number of other retired or separated participants entitled to future benefits | 2019-05-01 | 0 |
| Total of all active and inactive participants | 2019-05-01 | 1,354 |
| 2018: STONERISE HEALTHCARE LLC MEDICAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-05-01 | 1,363 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 1,394 |
| Number of retired or separated participants receiving benefits | 2018-05-01 | 7 |
| Number of other retired or separated participants entitled to future benefits | 2018-05-01 | 0 |
| Total of all active and inactive participants | 2018-05-01 | 1,401 |
| 2017: STONERISE HEALTHCARE LLC MEDICAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-05-01 | 1,719 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 2,087 |
| Number of retired or separated participants receiving benefits | 2017-05-01 | 18 |
| Number of other retired or separated participants entitled to future benefits | 2017-05-01 | 0 |
| Total of all active and inactive participants | 2017-05-01 | 2,105 |
| 2016: STONERISE HEALTHCARE LLC MEDICAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-05-01 | 1,547 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 1,436 |
| Number of retired or separated participants receiving benefits | 2016-05-01 | 3 |
| 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 | 1,439 |
| 2015: STONERISE HEALTHCARE LLC MEDICAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 444 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 990 |
| Total of all active and inactive participants | 2015-05-01 | 990 |
| Number of retired or separated participants receiving benefits | 2015-05-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2015-05-01 | 0 |
| 2014: STONERISE HEALTHCARE LLC MEDICAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 283 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 444 |
| Total of all active and inactive participants | 2014-05-01 | 444 |
| Number of retired or separated participants receiving benefits | 2014-05-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2014-05-01 | 0 |
| 2013: STONERISE HEALTHCARE LLC MEDICAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 217 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 278 |
| 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 | 278 |
| 2012: STONERISE HEALTHCARE LLC MEDICAL PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 123 |
| Total of all active and inactive participants | 2012-05-01 | 0 |
| 2011: STONERISE HEALTHCARE LLC MEDICAL PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-05-01 | 122 |
| 2010: STONERISE HEALTHCARE LLC MEDICAL PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-05-01 | 118 |
| 2009: STONERISE HEALTHCARE LLC MEDICAL PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-05-01 | 91 |
| 2008: STONERISE HEALTHCARE LLC MEDICAL PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-05-01 | 0 |
| Measure | Date | Value |
|---|
| 2016 : STONERISE HEALTHCARE LLC MEDICAL PLAN 2016 401k financial data |
|---|
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-04-30 | No |
| Was this plan covered by a fidelity bond | 2016-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2016-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-04-30 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-04-30 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-04-30 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-04-30 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-04-30 | No |
| Did the plan have assets held for investment | 2016-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-04-30 | No |
| 2013 : STONERISE HEALTHCARE LLC MEDICAL PLAN 2013 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2013-04-30 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-04-30 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-04-30 | $0 |
| Total income from all sources (including contributions) | 2013-04-30 | $0 |
| Total loss/gain on sale of assets | 2013-04-30 | $0 |
| Total of all expenses incurred | 2013-04-30 | $0 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-04-30 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-04-30 | $0 |
| Value of total assets at end of year | 2013-04-30 | $0 |
| Value of total assets at beginning of year | 2013-04-30 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-04-30 | $0 |
| Total interest from all sources | 2013-04-30 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-04-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-04-30 | No |
| Was this plan covered by a fidelity bond | 2013-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2013-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-04-30 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-04-30 | No |
| Value of net income/loss | 2013-04-30 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2013-04-30 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-04-30 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-04-30 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-04-30 | No |
| Did the plan have assets held for investment | 2013-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-04-30 | No |
| 2012 : STONERISE HEALTHCARE LLC MEDICAL PLAN 2012 401k financial data |
|---|
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-04-30 | No |
| Was this plan covered by a fidelity bond | 2012-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2012-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-04-30 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-04-30 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-04-30 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-04-30 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-04-30 | No |
| Did the plan have assets held for investment | 2012-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-04-30 | No |
| 2011 : STONERISE HEALTHCARE LLC MEDICAL PLAN 2011 401k financial data |
|---|
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-04-30 | No |
| Was this plan covered by a fidelity bond | 2011-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2011-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-04-30 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-04-30 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-04-30 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-04-30 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-04-30 | No |
| Did the plan have assets held for investment | 2011-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-04-30 | No |
| 2010 : STONERISE HEALTHCARE LLC MEDICAL PLAN 2010 401k financial data |
|---|
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-04-30 | No |
| Was this plan covered by a fidelity bond | 2010-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2010-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-04-30 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-04-30 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-04-30 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2010-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-04-30 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2010-04-30 | No |
| Did the plan have assets held for investment | 2010-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-04-30 | No |
| 2009 : STONERISE HEALTHCARE LLC MEDICAL PLAN 2009 401k financial data |
|---|
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2009-04-30 | No |
| Was this plan covered by a fidelity bond | 2009-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2009-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2009-04-30 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2009-04-30 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2009-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2009-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2009-04-30 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2009-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2009-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2009-04-30 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2009-04-30 | No |
| Did the plan have assets held for investment | 2009-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2009-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2009-04-30 | No |
| 2020: STONERISE HEALTHCARE LLC MEDICAL PLAN 2020 form 5500 responses |
|---|
| 2020-05-01 | Type of plan entity | Single employer plan |
| 2020-05-01 | Submission has been amended | Yes |
| 2020-05-01 | This submission is the final filing | No |
| 2020-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-05-01 | Plan is a collectively bargained plan | No |
| 2020-05-01 | Plan funding arrangement – Insurance | Yes |
| 2020-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: STONERISE HEALTHCARE LLC MEDICAL PLAN 2019 form 5500 responses |
|---|
| 2019-05-01 | Type of plan entity | Single employer plan |
| 2019-05-01 | Submission has been amended | No |
| 2019-05-01 | This submission is the final filing | No |
| 2019-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-05-01 | Plan is a collectively bargained plan | No |
| 2019-05-01 | Plan funding arrangement – Insurance | Yes |
| 2019-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: STONERISE HEALTHCARE LLC MEDICAL PLAN 2018 form 5500 responses |
|---|
| 2018-05-01 | Type of plan entity | Single employer plan |
| 2018-05-01 | Submission has been amended | No |
| 2018-05-01 | This submission is the final filing | No |
| 2018-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-05-01 | Plan is a collectively bargained plan | No |
| 2018-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: STONERISE HEALTHCARE LLC MEDICAL PLAN 2017 form 5500 responses |
|---|
| 2017-05-01 | Type of plan entity | Single employer plan |
| 2017-05-01 | Submission has been amended | No |
| 2017-05-01 | This submission is the final filing | No |
| 2017-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-05-01 | Plan is a collectively bargained plan | No |
| 2017-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: STONERISE HEALTHCARE LLC MEDICAL PLAN 2016 form 5500 responses |
|---|
| 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) | No |
| 2016-05-01 | Plan is a collectively bargained plan | No |
| 2016-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: STONERISE HEALTHCARE LLC MEDICAL PLAN 2015 form 5500 responses |
|---|
| 2015-05-01 | Type of plan entity | Single employer plan |
| 2015-05-01 | Submission has been amended | Yes |
| 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 funding arrangement – General assets of the sponsor | Yes |
| 2015-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: STONERISE HEALTHCARE LLC MEDICAL PLAN 2014 form 5500 responses |
|---|
| 2014-05-01 | Type of plan entity | Single employer plan |
| 2014-05-01 | Submission has been amended | Yes |
| 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 funding arrangement – General assets of the sponsor | Yes |
| 2014-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: STONERISE HEALTHCARE LLC MEDICAL PLAN 2013 form 5500 responses |
|---|
| 2013-05-01 | Type of plan entity | Single employer plan |
| 2013-05-01 | First time form 5500 has been submitted | Yes |
| 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: STONERISE HEALTHCARE LLC MEDICAL PLAN 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: STONERISE HEALTHCARE LLC MEDICAL PLAN 2011 form 5500 responses |
|---|
| 2011-05-01 | Type of plan entity | Single employer plan |
| 2011-05-01 | Plan funding arrangement – Insurance | Yes |
| 2011-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: STONERISE HEALTHCARE LLC MEDICAL PLAN 2010 form 5500 responses |
|---|
| 2010-05-01 | Type of plan entity | Single employer plan |
| 2010-05-01 | Plan funding arrangement – Insurance | Yes |
| 2010-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: STONERISE HEALTHCARE LLC MEDICAL PLAN 2009 form 5500 responses |
|---|
| 2009-05-01 | Type of plan entity | Single employer plan |
| 2009-05-01 | Plan funding arrangement – Insurance | Yes |
| 2009-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: STONERISE HEALTHCARE LLC MEDICAL PLAN 2008 form 5500 responses |
|---|
| 2008-05-01 | Type of plan entity | Single employer plan |
| 2008-05-01 | First time form 5500 has been submitted | Yes |
| 2008-05-01 | Plan funding arrangement – Insurance | Yes |
| 2008-05-01 | Plan benefit arrangement – Insurance | Yes |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0214435 |
| Policy instance | 1 |
| Insurance contract or identification number | 0214435 | | Number of Individuals Covered | 3250 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $112,446 | | Total amount of fees paid to insurance company | USD $44,690 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,225,728 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $112,446 | | Amount paid for insurance broker fees | 44690 | | Additional information about fees paid to insurance broker | SERVICE FEES AND SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0214435 |
| Policy instance | 1 |
| Insurance contract or identification number | 0214435 | | Number of Individuals Covered | 3349 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $131,193 | | Total amount of fees paid to insurance company | USD $57,113 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,289,854 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $131,193 | | Amount paid for insurance broker fees | 57113 | | Additional information about fees paid to insurance broker | SERVICE FEES AND SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
| Policy contract number | 09098177 |
| Policy instance | 1 |
| Insurance contract or identification number | 09098177 | | Number of Individuals Covered | 990 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $28 | | Total amount of fees paid to insurance company | USD $0 | | Health 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 $30 | | Insurance broker name | JACK GRIMM |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00435213 |
| Policy instance | 2 |
| Insurance contract or identification number | 00435213 | | Number of Individuals Covered | 1505 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $45,343 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,343 | | Insurance broker name | RICK BURKA |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00435213 |
| Policy instance | 2 |
| Insurance contract or identification number | 00435213 | | Number of Individuals Covered | 1049 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $27,156 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,156 | | Insurance broker name | RICK BURKA |
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| HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
| Policy contract number | 09098177 |
| Policy instance | 1 |
| Insurance contract or identification number | 09098177 | | Number of Individuals Covered | 444 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Total amount of commissions paid to insurance broker | USD $24,096 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,066 | | Insurance broker name | RICK BURKA |
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| HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
| Policy contract number | 106890 |
| Policy instance | 1 |
| Insurance contract or identification number | 106890 | | Number of Individuals Covered | 433 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $61,609 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,940,410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $61,609 | | Insurance broker organization code? | 3 | | Insurance broker name | JACK GRIMM |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00435213 |
| Policy instance | 2 |
| Insurance contract or identification number | 00435213 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2012-01-31 | | Total amount of commissions paid to insurance broker | USD $3,042 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,042 | | Insurance broker name | RICK BURKA |
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| HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
| Policy contract number | 09098177 |
| Policy instance | 1 |
| Insurance contract or identification number | 09098177 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $766 | | Total amount of fees paid to insurance company | USD $0 | | Health 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 $766 | | Insurance broker name | ROSS JOHNSON |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00435213 |
| Policy instance | 2 |
| Insurance contract or identification number | 00435213 | | Number of Individuals Covered | 195 | | Insurance policy start date | 2010-02-01 | | Insurance policy end date | 2011-01-31 | | Total amount of commissions paid to insurance broker | USD $3,994 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,994 | | Insurance broker name | RICK BURKA |
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| HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
| Policy contract number | 09098177 |
| Policy instance | 1 |
| Insurance contract or identification number | 09098177 | | Number of Individuals Covered | 192 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $523 | | Total amount of fees paid to insurance company | USD $0 | | Health 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 $523 | | Insurance broker name | RICK BURKA |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00435213 |
| Policy instance | 2 |
| Insurance contract or identification number | 00435213 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2009-02-01 | | Insurance policy end date | 2010-01-31 | | Total amount of commissions paid to insurance broker | USD $4,948 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,523 | | Insurance broker name | LIFETIME FINANCIAL GROWTH |
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| HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
| Policy contract number | 09098177 |
| Policy instance | 1 |
| Insurance contract or identification number | 09098177 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2009-01-01 | | Insurance policy end date | 2009-12-31 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00435213 |
| Policy instance | 2 |
| Insurance contract or identification number | 00435213 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2008-01-31 | | Insurance policy end date | 2009-02-01 | | Total amount of commissions paid to insurance broker | USD $4,736 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,406 | | Insurance broker name | LIFETIME FINANCIAL GROWTH |
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| HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
| Policy contract number | 09098177 |
| Policy instance | 1 |
| Insurance contract or identification number | 09098177 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2008-01-01 | | Insurance policy end date | 2008-12-31 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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