THE OHIO AUTOMOBILE CLUB has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE OHIO AUTOMOBILE HEALTH CARE PLAN
Measure | Date | Value |
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2022: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 292 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 312 |
Total of all active and inactive participants | 2022-01-01 | 312 |
Total participants | 2022-01-01 | 312 |
2021: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 305 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 292 |
Total of all active and inactive participants | 2021-01-01 | 292 |
Total participants | 2021-01-01 | 292 |
2020: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 373 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 305 |
Total of all active and inactive participants | 2020-01-01 | 305 |
Total participants | 2020-01-01 | 305 |
2019: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 403 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 373 |
Total of all active and inactive participants | 2019-01-01 | 373 |
Total participants | 2019-01-01 | 373 |
2018: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 413 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 403 |
Total of all active and inactive participants | 2018-01-01 | 403 |
Total participants | 2018-01-01 | 403 |
2017: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 429 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 395 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 18 |
Total of all active and inactive participants | 2017-01-01 | 413 |
Total participants | 2017-01-01 | 413 |
2016: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 429 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 389 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 18 |
Total of all active and inactive participants | 2016-01-01 | 407 |
Total participants | 2016-01-01 | 407 |
2015: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 427 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 411 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 18 |
Total of all active and inactive participants | 2015-01-01 | 429 |
Total participants | 2015-01-01 | 429 |
2014: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 421 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 427 |
Total of all active and inactive participants | 2014-01-01 | 427 |
Total participants | 2014-01-01 | 427 |
2013: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 448 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 421 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 421 |
Total participants | 2013-01-01 | 421 |
2012: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 438 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 448 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 448 |
Total participants | 2012-01-01 | 448 |
2011: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 432 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 438 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
Total of all active and inactive participants | 2011-01-01 | 438 |
Total participants | 2011-01-01 | 438 |
2010: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-01-01 | 474 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 418 |
Number of retired or separated participants receiving benefits | 2010-01-01 | 9 |
Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 5 |
Total of all active and inactive participants | 2010-01-01 | 432 |
Total participants | 2010-01-01 | 432 |
2009: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 489 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 440 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 28 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 6 |
Total of all active and inactive participants | 2009-01-01 | 474 |
2022: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Submission has been amended | No |
2022-01-01 | This submission is the final filing | No |
2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-01-01 | Plan is a collectively bargained plan | No |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Submission has been amended | No |
2021-01-01 | This submission is the final filing | No |
2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-01-01 | Plan is a collectively bargained plan | No |
2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2020 form 5500 responses |
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Submission has been amended | No |
2020-01-01 | This submission is the final filing | No |
2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-01-01 | Plan is a collectively bargained plan | No |
2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2019 form 5500 responses |
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2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Submission has been amended | No |
2019-01-01 | This submission is the final filing | No |
2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-01-01 | Plan is a collectively bargained plan | No |
2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Submission has been amended | No |
2018-01-01 | This submission is the final filing | No |
2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-01-01 | Plan is a collectively bargained plan | No |
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: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Submission has been amended | No |
2017-01-01 | This submission is the final filing | No |
2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-01-01 | Plan is a collectively bargained plan | No |
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: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
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: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-01-01 | Plan is a collectively bargained plan | No |
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: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | No |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
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: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | No |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
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: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Submission has been amended | No |
2012-01-01 | This submission is the final filing | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-01-01 | Plan is a collectively bargained plan | No |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Submission has been amended | No |
2011-01-01 | This submission is the final filing | No |
2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-01-01 | Plan is a collectively bargained plan | No |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2010: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2010 form 5500 responses |
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2010-01-01 | Type of plan entity | Single employer plan |
2010-01-01 | Submission has been amended | No |
2010-01-01 | This submission is the final filing | No |
2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-01-01 | Plan is a collectively bargained plan | No |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: THE OHIO AUTOMOBILE HEALTH CARE PLAN 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Submission has been amended | No |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-01-01 | Plan is a collectively bargained plan | No |
2009-01-01 | Plan funding arrangement – Trust | Yes |
2009-01-01 | Plan benefit arrangement - Trust | Yes |
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 417009410876 |
Policy instance | 1 |
Insurance contract or identification number | 417009410876 | Number of Individuals Covered | 312 | Insurance policy start date | 2022-01-01 | 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 $3,518 | 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 | 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 $472,258 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 3518 | Additional information about fees paid to insurance broker | SUPP COMPENSATION | Insurance broker organization code? | 3 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 70429-6 |
Policy instance | 1 |
Insurance contract or identification number | 70429-6 | Number of Individuals Covered | 297 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $9,850 | 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 | No | 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 $530,780 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,850 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | SUPP COMPENSATION | Insurance broker organization code? | 3 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 70429-6 |
Policy instance | 1 |
Insurance contract or identification number | 70429-6 | Number of Individuals Covered | 307 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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 | 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 $513,523 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 14473 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 417004410876 |
Policy instance | 1 |
Insurance contract or identification number | 417004410876 | Number of Individuals Covered | 395 | 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 $48,510 | 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 | 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 $388,231 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 48510 | Additional information about fees paid to insurance broker | SERVICE | Insurance broker organization code? | 3 | Insurance broker name | CLEARPATH BENEFIT ADVISORS LLC |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 417004410876 |
Policy instance | 1 |
Insurance contract or identification number | 417004410876 | Number of Individuals Covered | 429 | Insurance policy start date | 2015-01-01 | 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 $51,370 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $266,000 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 51370 | Additional information about fees paid to insurance broker | SERVICE | Insurance broker organization code? | 3 | Insurance broker name | CLEARPATH BENEFIT ADVISORS, LLC |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 417004410876 |
Policy instance | 1 |
Insurance contract or identification number | 417004410876 | Number of Individuals Covered | 427 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $46,250 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $170,644 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 46250 | Additional information about fees paid to insurance broker | SERVICE | Insurance broker organization code? | 3 | Insurance broker name | CLEARPATH BENEFIT ADVISORS, LLC |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 417004410876 |
Policy instance | 1 |
Insurance contract or identification number | 417004410876 | Number of Individuals Covered | 421 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of fees paid to insurance company | USD $52,360 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $134,977 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 52360 | Additional information about fees paid to insurance broker | SERVICE | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM SHIMP |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 417003410876 |
Policy instance | 1 |
Insurance contract or identification number | 417003410876 | Number of Individuals Covered | 448 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of fees paid to insurance company | USD $51,580 | Welfare Benefit Premiums Paid to Carrier | USD $149,783 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 51580 | Additional information about fees paid to insurance broker | SERVICE | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM SHIMP |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 417003410876 |
Policy instance | 1 |
Insurance contract or identification number | 417003410876 | Number of Individuals Covered | 438 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of fees paid to insurance company | USD $52,220 | Welfare Benefit Premiums Paid to Carrier | USD $140,081 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 069196 |
Policy instance | 1 |
Insurance contract or identification number | 069196 | Number of Individuals Covered | 432 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $25,620 | Welfare Benefit Premiums Paid to Carrier | USD $232,159 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 4320 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $21,300 | Insurance broker name | EMPLOYEE BENEFIT MANAGEMENT |
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