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EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 401k Plan overview

Plan NameEMPOWER MEDIA MARKETING, INC. GROUP HEALTH
Plan identification number 503

EMPOWER MEDIA MARKETING, INC. GROUP HEALTH Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    EMPOWER MEDIAMARKETING, INC. has sponsored the creation of one or more 401k plans.

    Company Name:EMPOWER MEDIAMARKETING, INC.
    Employer identification number (EIN):311159220
    NAIC Classification:541800

    Additional information about EMPOWER MEDIAMARKETING, INC.

    Jurisdiction of Incorporation: Texas Secretary of State
    Incorporation Date: 2005-08-19
    Company Identification Number: 0800534753
    Legal Registered Office Address: 15 E 14TH ST

    CINCINNATI
    United States of America (USA)
    45202

    More information about EMPOWER MEDIAMARKETING, INC.

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan EMPOWER MEDIA MARKETING, INC. GROUP HEALTH

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5032020-01-01
    5032019-01-01
    5032018-01-01JOSEPH LOWRY JOSEPH LOWRY2019-06-26
    5032017-01-01JOSEPH
    5032016-01-01JOE LOWRY
    5032015-01-01JOE LOWRY
    5032014-01-01JOSEPH LOWRY
    5032013-01-01JOE LOWRY
    5032012-01-01JOSEPH LOWRY JOSEPH LOWRY2013-08-06
    5032011-01-01JOE LOWRY
    5032009-01-01JOE LOWRY JOE LOWRY2010-07-20

    Plan Statistics for EMPOWER MEDIA MARKETING, INC. GROUP HEALTH

    401k plan membership statisitcs for EMPOWER MEDIA MARKETING, INC. GROUP HEALTH

    Measure Date Value
    2020: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2020 401k membership
    Total participants, beginning-of-year2020-01-01164
    Total number of active participants reported on line 7a of the Form 55002020-01-01173
    Total of all active and inactive participants2020-01-01173
    2019: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2019 401k membership
    Total participants, beginning-of-year2019-01-01141
    Total number of active participants reported on line 7a of the Form 55002019-01-01164
    Total of all active and inactive participants2019-01-01164
    2018: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2018 401k membership
    Total participants, beginning-of-year2018-01-01129
    Total number of active participants reported on line 7a of the Form 55002018-01-01141
    Total of all active and inactive participants2018-01-01141
    2017: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2017 401k membership
    Total participants, beginning-of-year2017-01-01132
    Total number of active participants reported on line 7a of the Form 55002017-01-01129
    Total of all active and inactive participants2017-01-01129
    2016: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2016 401k membership
    Total participants, beginning-of-year2016-01-01151
    Total number of active participants reported on line 7a of the Form 55002016-01-01132
    Total of all active and inactive participants2016-01-01132
    2015: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2015 401k membership
    Total participants, beginning-of-year2015-01-01151
    Total number of active participants reported on line 7a of the Form 55002015-01-01151
    Total of all active and inactive participants2015-01-01151
    2014: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2014 401k membership
    Total participants, beginning-of-year2014-01-01149
    Total number of active participants reported on line 7a of the Form 55002014-01-01151
    Total of all active and inactive participants2014-01-01151
    2013: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2013 401k membership
    Total participants, beginning-of-year2013-01-01168
    Total number of active participants reported on line 7a of the Form 55002013-01-01149
    Total of all active and inactive participants2013-01-01149
    2012: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2012 401k membership
    Total participants, beginning-of-year2012-01-01154
    Total number of active participants reported on line 7a of the Form 55002012-01-01168
    Total of all active and inactive participants2012-01-01168
    2011: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2011 401k membership
    Total participants, beginning-of-year2011-01-01144
    Total number of active participants reported on line 7a of the Form 55002011-01-01154
    Total of all active and inactive participants2011-01-01154
    2009: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2009 401k membership
    Total participants, beginning-of-year2009-01-01148
    Total number of active participants reported on line 7a of the Form 55002009-01-01138
    Total of all active and inactive participants2009-01-01138

    Form 5500 Responses for EMPOWER MEDIA MARKETING, INC. GROUP HEALTH

    2020: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2020 form 5500 responses
    2020-01-01Type of plan entitySingle employer plan
    2020-01-01Submission has been amendedNo
    2020-01-01This submission is the final filingNo
    2020-01-01This return/report is a short plan year return/report (less than 12 months)No
    2020-01-01Plan is a collectively bargained planNo
    2020-01-01Plan funding arrangement – InsuranceYes
    2020-01-01Plan benefit arrangement – InsuranceYes
    2019: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2019 form 5500 responses
    2019-01-01Type of plan entitySingle employer plan
    2019-01-01Submission has been amendedNo
    2019-01-01This submission is the final filingNo
    2019-01-01This return/report is a short plan year return/report (less than 12 months)No
    2019-01-01Plan is a collectively bargained planNo
    2019-01-01Plan funding arrangement – InsuranceYes
    2019-01-01Plan benefit arrangement – InsuranceYes
    2018: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2018 form 5500 responses
    2018-01-01Type of plan entitySingle employer plan
    2018-01-01Submission has been amendedNo
    2018-01-01This submission is the final filingNo
    2018-01-01This return/report is a short plan year return/report (less than 12 months)No
    2018-01-01Plan is a collectively bargained planNo
    2018-01-01Plan funding arrangement – InsuranceYes
    2018-01-01Plan benefit arrangement – InsuranceYes
    2017: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2017 form 5500 responses
    2017-01-01Type of plan entitySingle employer plan
    2017-01-01Submission has been amendedNo
    2017-01-01This submission is the final filingNo
    2017-01-01This return/report is a short plan year return/report (less than 12 months)No
    2017-01-01Plan is a collectively bargained planNo
    2017-01-01Plan funding arrangement – InsuranceYes
    2017-01-01Plan benefit arrangement – InsuranceYes
    2016: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2016 form 5500 responses
    2016-01-01Type of plan entitySingle employer plan
    2016-01-01Submission has been amendedNo
    2016-01-01This submission is the final filingNo
    2016-01-01This return/report is a short plan year return/report (less than 12 months)No
    2016-01-01Plan is a collectively bargained planNo
    2016-01-01Plan funding arrangement – InsuranceYes
    2016-01-01Plan benefit arrangement – InsuranceYes
    2015: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2015 form 5500 responses
    2015-01-01Type of plan entitySingle employer plan
    2015-01-01Submission has been amendedNo
    2015-01-01This submission is the final filingNo
    2015-01-01This return/report is a short plan year return/report (less than 12 months)No
    2015-01-01Plan is a collectively bargained planNo
    2015-01-01Plan funding arrangement – InsuranceYes
    2015-01-01Plan benefit arrangement – InsuranceYes
    2014: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2014 form 5500 responses
    2014-01-01Type of plan entitySingle employer plan
    2014-01-01Submission has been amendedNo
    2014-01-01This submission is the final filingNo
    2014-01-01This return/report is a short plan year return/report (less than 12 months)No
    2014-01-01Plan is a collectively bargained planNo
    2014-01-01Plan funding arrangement – InsuranceYes
    2014-01-01Plan benefit arrangement – InsuranceYes
    2013: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2013 form 5500 responses
    2013-01-01Type of plan entitySingle employer plan
    2013-01-01Submission has been amendedNo
    2013-01-01This submission is the final filingNo
    2013-01-01This return/report is a short plan year return/report (less than 12 months)No
    2013-01-01Plan is a collectively bargained planNo
    2013-01-01Plan funding arrangement – InsuranceYes
    2013-01-01Plan benefit arrangement – InsuranceYes
    2012: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2012 form 5500 responses
    2012-01-01Type of plan entitySingle employer plan
    2012-01-01Submission has been amendedNo
    2012-01-01This submission is the final filingNo
    2012-01-01This return/report is a short plan year return/report (less than 12 months)No
    2012-01-01Plan is a collectively bargained planNo
    2012-01-01Plan funding arrangement – InsuranceYes
    2012-01-01Plan benefit arrangement – InsuranceYes
    2011: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2011 form 5500 responses
    2011-01-01Type of plan entitySingle employer plan
    2011-01-01Submission has been amendedNo
    2011-01-01This submission is the final filingNo
    2011-01-01This return/report is a short plan year return/report (less than 12 months)No
    2011-01-01Plan is a collectively bargained planNo
    2011-01-01Plan funding arrangement – InsuranceYes
    2011-01-01Plan benefit arrangement – InsuranceYes
    2009: EMPOWER MEDIA MARKETING, INC. GROUP HEALTH 2009 form 5500 responses
    2009-01-01Type of plan entitySingle employer plan
    2009-01-01Submission has been amendedNo
    2009-01-01This submission is the final filingNo
    2009-01-01This return/report is a short plan year return/report (less than 12 months)No
    2009-01-01Plan is a collectively bargained planNo
    2009-01-01Plan funding arrangement – InsuranceYes
    2009-01-01Plan funding arrangement – General assets of the sponsorYes
    2009-01-01Plan benefit arrangement – InsuranceYes
    2009-01-01Plan benefit arrangement – General assets of the sponsorYes

    Insurance Providers Used on plan

    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number639295
    Policy instance 3
    Insurance contract or identification number639295
    Number of Individuals Covered128
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $1,803
    Total amount of fees paid to insurance companyUSD $73
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $18,206
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,803
    Amount paid for insurance broker fees73
    Additional information about fees paid to insurance brokerBONUS
    Insurance broker organization code?3
    HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
    Policy contract number639295
    Policy instance 2
    Insurance contract or identification number639295
    Number of Individuals Covered173
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $41,249
    Total amount of fees paid to insurance companyUSD $4,583
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $1,412,331
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $41,249
    Amount paid for insurance broker fees4583
    Additional information about fees paid to insurance brokerBONUS
    Insurance broker organization code?3
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201/501
    Policy instance 1
    Insurance contract or identification number6466201/501
    Number of Individuals Covered335
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $6,242
    Total amount of fees paid to insurance companyUSD $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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $6,242
    Insurance broker organization code?3
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201/501
    Policy instance 1
    Insurance contract or identification number6466201/501
    Number of Individuals Covered166
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $6,512
    Total amount of fees paid to insurance companyUSD $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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $6,512
    Insurance broker organization code?3
    HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
    Policy contract number639295
    Policy instance 2
    Insurance contract or identification number639295
    Number of Individuals Covered164
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $39,072
    Total amount of fees paid to insurance companyUSD $5,284
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $1,346,402
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $39,072
    Amount paid for insurance broker fees5284
    Additional information about fees paid to insurance brokerBONUS
    Insurance broker organization code?3
    COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 )
    Policy contract number639295
    Policy instance 3
    Insurance contract or identification number639295
    Number of Individuals Covered123
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $1,710
    Total amount of fees paid to insurance companyUSD $144
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $17,396
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,710
    Amount paid for insurance broker fees144
    Additional information about fees paid to insurance brokerBONUS
    Insurance broker organization code?3
    HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
    Policy contract number639295
    Policy instance 3
    Insurance contract or identification number639295
    Number of Individuals Covered141
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $37,772
    Total amount of fees paid to insurance companyUSD $6,971
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $1,269,650
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $37,772
    Amount paid for insurance broker fees6971
    Additional information about fees paid to insurance brokerBONUS
    Insurance broker organization code?3
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466801
    Policy instance 2
    Insurance contract or identification number6466801
    Number of Individuals Covered17
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $616
    Total amount of fees paid to insurance companyUSD $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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $616
    Insurance broker organization code?3
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201/501
    Policy instance 1
    Insurance contract or identification number6466201/501
    Number of Individuals Covered125
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $4,988
    Total amount of fees paid to insurance companyUSD $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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,988
    Insurance broker organization code?3
    COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 )
    Policy contract number639295
    Policy instance 4
    Insurance contract or identification number639295
    Number of Individuals Covered106
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $1,494
    Total amount of fees paid to insurance companyUSD $257
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $15,106
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,494
    Amount paid for insurance broker fees257
    Additional information about fees paid to insurance brokerBONUS
    Insurance broker organization code?3
    HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
    Policy contract number639295
    Policy instance 2
    Insurance contract or identification number639295
    Number of Individuals Covered129
    Insurance policy start date2016-04-01
    Insurance policy end date2017-03-31
    Total amount of commissions paid to insurance brokerUSD $32,340
    Total amount of fees paid to insurance companyUSD $9,761
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $1,080,601
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $32,340
    Amount paid for insurance broker fees9761
    Additional information about fees paid to insurance brokerBONUS
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES INC
    COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 )
    Policy contract number639295
    Policy instance 3
    Insurance contract or identification number639295
    Number of Individuals Covered95
    Insurance policy start date2016-04-01
    Insurance policy end date2017-03-31
    Total amount of commissions paid to insurance brokerUSD $1,194
    Total amount of fees paid to insurance companyUSD $220
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $11,965
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,194
    Amount paid for insurance broker fees220
    Additional information about fees paid to insurance brokerBONUS
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES, INC.
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201/501
    Policy instance 1
    Insurance contract or identification number6466201/501
    Number of Individuals Covered119
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $4,943
    Total amount of fees paid to insurance companyUSD $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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,943
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES INC
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201/501
    Policy instance 1
    Insurance contract or identification number6466201/501
    Number of Individuals Covered136
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $5,508
    Total amount of fees paid to insurance companyUSD $0
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,508
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES INC
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number639295
    Policy instance 2
    Insurance contract or identification number639295
    Number of Individuals Covered151
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-31
    Total amount of commissions paid to insurance brokerUSD $34,754
    Total amount of fees paid to insurance companyUSD $6,996
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $1,111,013
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $34,754
    Amount paid for insurance broker fees6996
    Additional information about fees paid to insurance brokerVOLUME INCENTIVES AND NON-MONETARY PAID
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES INC
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number639295
    Policy instance 2
    Insurance contract or identification number639295
    Number of Individuals Covered195
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $29,419
    Total amount of fees paid to insurance companyUSD $22,230
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $871,568
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $29,419
    Amount paid for insurance broker fees22230
    Additional information about fees paid to insurance brokerVOLUME INCENTIVES
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES INC
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201/501
    Policy instance 1
    Insurance contract or identification number6466201/501
    Number of Individuals Covered148
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $5,392
    Total amount of fees paid to insurance companyUSD $0
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,392
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES INC
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201/501
    Policy instance 1
    Insurance contract or identification number6466201/501
    Number of Individuals Covered149
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $5,220
    Total amount of fees paid to insurance companyUSD $0
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,220
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES, INC.
    COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 )
    Policy contract number639295
    Policy instance 2
    Insurance contract or identification number639295
    Number of Individuals Covered107
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $1,294
    Total amount of fees paid to insurance companyUSD $638
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $13,118
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,294
    Amount paid for insurance broker fees638
    Additional information about fees paid to insurance brokerVOLUME INCENTIVES
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES, INC.
    COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
    Policy contract number00171268
    Policy instance 3
    Insurance contract or identification number00171268
    Number of Individuals Covered145
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $24,944
    Total amount of fees paid to insurance companyUSD $0
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $540,599
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,077
    Insurance broker organization code?3
    Insurance broker nameTHE JAMES B. OSWALD COMPANY
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201/501
    Policy instance 1
    Insurance contract or identification number6466201/501
    Number of Individuals Covered168
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Total amount of commissions paid to insurance brokerUSD $5,470
    Total amount of fees paid to insurance companyUSD $0
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,470
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES, INC.
    COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 )
    Policy contract number639295
    Policy instance 2
    Insurance contract or identification number639295
    Number of Individuals Covered107
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Total amount of commissions paid to insurance brokerUSD $1,184
    Total amount of fees paid to insurance companyUSD $310
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $14,132
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,184
    Amount paid for insurance broker fees310
    Additional information about fees paid to insurance brokerVOLUME INCENTIVES NON-MONETARY
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES, INC.
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201/501
    Policy instance 1
    Insurance contract or identification number6466201/501
    Number of Individuals Covered153
    Insurance policy start date2010-04-01
    Insurance policy end date2011-03-31
    Total amount of commissions paid to insurance brokerUSD $4,878
    Total amount of fees paid to insurance companyUSD $0
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number639295
    Policy instance 2
    Insurance contract or identification number639295
    Number of Individuals Covered154
    Insurance policy start date2010-04-01
    Insurance policy end date2011-03-31
    Total amount of commissions paid to insurance brokerUSD $28,500
    Total amount of fees paid to insurance companyUSD $14,353
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $942,850
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number639295
    Policy instance 3
    Insurance contract or identification number639295
    Number of Individuals Covered144
    Insurance policy start date2009-04-01
    Insurance policy end date2010-03-31
    Total amount of commissions paid to insurance brokerUSD $26,341
    Total amount of fees paid to insurance companyUSD $4,541
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $897,613
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $26,341
    Amount paid for insurance broker fees4541
    Additional information about fees paid to insurance brokerVOLUME INCENTIVES
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES, INC.
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number9692617
    Policy instance 2
    Insurance contract or identification number9692617
    Number of Individuals Covered119
    Insurance policy start date2009-04-01
    Insurance policy end date2010-03-31
    Total amount of commissions paid to insurance brokerUSD $1,015
    Total amount of fees paid to insurance companyUSD $0
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    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 CarrierUSD $10,155
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,015
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES, INC.
    DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
    Policy contract number6466201&6466501
    Policy instance 1
    Insurance contract or identification number6466201&6466501
    Number of Individuals Covered271
    Insurance policy start date2009-04-01
    Insurance policy end date2010-03-31
    Total amount of commissions paid to insurance brokerUSD $4,664
    Total amount of fees paid to insurance companyUSD $0
    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 planNo
    Contracts With Unallocated Funds Deposit Administration0
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,664
    Insurance broker organization code?3
    Insurance broker nameHORAN ASSOCIATES, INC.

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