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AHF INSURANCE PLANS 401k Plan overview

Plan NameAHF INSURANCE PLANS
Plan identification number 501

AHF INSURANCE PLANS Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    AMERICAN HEALTH FOUNDATION, INC. has sponsored the creation of one or more 401k plans.

    Company Name:AMERICAN HEALTH FOUNDATION, INC.
    Employer identification number (EIN):311311729
    NAIC Classification:623000
    NAIC Description: Nursing and Residential Care Facilities

    Additional information about AMERICAN HEALTH FOUNDATION, INC.

    Jurisdiction of Incorporation: Florida Department of State Division of Corporations
    Incorporation Date: 2009-09-24
    Company Identification Number: N09000009367
    Legal Registered Office Address: 10240 SW 56 ST

    Miami

    33165

    More information about AMERICAN HEALTH FOUNDATION, INC.

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan AHF INSURANCE PLANS

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5012016-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2017-10-27
    5012016-01-01 J MICHAEL HAEMMERLE2017-10-10
    5012015-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2016-10-17
    5012015-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2016-12-07
    5012014-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2015-10-15
    5012014-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2015-10-21
    5012013-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2014-10-15
    5012012-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2013-09-26
    5012011-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2012-10-08
    5012010-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2011-10-13
    5012009-01-01J MICHAEL HAEMMERLE J MICHAEL HAEMMERLE2010-10-07

    Plan Statistics for AHF INSURANCE PLANS

    401k plan membership statisitcs for AHF INSURANCE PLANS

    Measure Date Value
    2016: AHF INSURANCE PLANS 2016 401k membership
    Total participants, beginning-of-year2016-01-01446
    Total number of active participants reported on line 7a of the Form 55002016-01-01370
    Number of retired or separated participants receiving benefits2016-01-010
    Number of other retired or separated participants entitled to future benefits2016-01-010
    Total of all active and inactive participants2016-01-01370
    2015: AHF INSURANCE PLANS 2015 401k membership
    Total participants, beginning-of-year2015-01-01498
    Total number of active participants reported on line 7a of the Form 55002015-01-01446
    Number of retired or separated participants receiving benefits2015-01-010
    Number of other retired or separated participants entitled to future benefits2015-01-010
    Total of all active and inactive participants2015-01-01446
    2014: AHF INSURANCE PLANS 2014 401k membership
    Total participants, beginning-of-year2014-01-01498
    Total number of active participants reported on line 7a of the Form 55002014-01-010
    Number of retired or separated participants receiving benefits2014-01-010
    Number of other retired or separated participants entitled to future benefits2014-01-010
    Total of all active and inactive participants2014-01-010
    2013: AHF INSURANCE PLANS 2013 401k membership
    Total participants, beginning-of-year2013-01-01584
    Total number of active participants reported on line 7a of the Form 55002013-01-01498
    Number of retired or separated participants receiving benefits2013-01-010
    Number of other retired or separated participants entitled to future benefits2013-01-010
    Total of all active and inactive participants2013-01-01498
    2012: AHF INSURANCE PLANS 2012 401k membership
    Total participants, beginning-of-year2012-01-01603
    Total number of active participants reported on line 7a of the Form 55002012-01-01584
    Number of retired or separated participants receiving benefits2012-01-010
    Number of other retired or separated participants entitled to future benefits2012-01-010
    Total of all active and inactive participants2012-01-01584
    2011: AHF INSURANCE PLANS 2011 401k membership
    Total participants, beginning-of-year2011-01-01573
    Total number of active participants reported on line 7a of the Form 55002011-01-01603
    Number of retired or separated participants receiving benefits2011-01-010
    Number of other retired or separated participants entitled to future benefits2011-01-010
    Total of all active and inactive participants2011-01-01603
    2010: AHF INSURANCE PLANS 2010 401k membership
    Total participants, beginning-of-year2010-01-01607
    Total number of active participants reported on line 7a of the Form 55002010-01-01573
    Number of retired or separated participants receiving benefits2010-01-010
    Number of other retired or separated participants entitled to future benefits2010-01-010
    Total of all active and inactive participants2010-01-01573
    2009: AHF INSURANCE PLANS 2009 401k membership
    Total participants, beginning-of-year2009-01-01601
    Total number of active participants reported on line 7a of the Form 55002009-01-01607
    Number of retired or separated participants receiving benefits2009-01-010
    Number of other retired or separated participants entitled to future benefits2009-01-010
    Total of all active and inactive participants2009-01-01607

    Form 5500 Responses for AHF INSURANCE PLANS

    2016: AHF INSURANCE PLANS 2016 form 5500 responses
    2016-01-01Type of plan entitySingle employer plan
    2016-01-01Submission has been amendedYes
    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: AHF INSURANCE PLANS 2015 form 5500 responses
    2015-01-01Type of plan entitySingle employer plan
    2015-01-01Submission has been amendedYes
    2015-01-01Plan funding arrangement – InsuranceYes
    2015-01-01Plan benefit arrangement – InsuranceYes
    2014: AHF INSURANCE PLANS 2014 form 5500 responses
    2014-01-01Type of plan entitySingle employer plan
    2014-01-01Submission has been amendedYes
    2014-01-01Plan funding arrangement – InsuranceYes
    2014-01-01Plan benefit arrangement – InsuranceYes
    2013: AHF INSURANCE PLANS 2013 form 5500 responses
    2013-01-01Type of plan entitySingle employer plan
    2013-01-01Plan funding arrangement – InsuranceYes
    2013-01-01Plan benefit arrangement – InsuranceYes
    2012: AHF INSURANCE PLANS 2012 form 5500 responses
    2012-01-01Type of plan entitySingle employer plan
    2012-01-01Plan funding arrangement – InsuranceYes
    2012-01-01Plan benefit arrangement – InsuranceYes
    2011: AHF INSURANCE PLANS 2011 form 5500 responses
    2011-01-01Type of plan entitySingle employer plan
    2011-01-01Plan funding arrangement – InsuranceYes
    2011-01-01Plan benefit arrangement – InsuranceYes
    2010: AHF INSURANCE PLANS 2010 form 5500 responses
    2010-01-01Type of plan entitySingle employer plan
    2010-01-01Plan funding arrangement – InsuranceYes
    2010-01-01Plan benefit arrangement – InsuranceYes
    2009: AHF INSURANCE PLANS 2009 form 5500 responses
    2009-01-01Type of plan entitySingle employer plan
    2009-01-01Plan funding arrangement – InsuranceYes
    2009-01-01Plan benefit arrangement – InsuranceYes

    Insurance Providers Used on plan

    UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
    Policy contract number007094305
    Policy instance 2
    Insurance contract or identification number007094305
    Number of Individuals Covered12
    Insurance policy start date2015-06-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $1,960
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $55,995
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $1,960
    Insurance broker organization code?3
    Insurance broker nameANDERSON & KIME EMPLOYEE BENEFITS
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number0902229
    Policy instance 6
    Insurance contract or identification number0902229
    Number of Individuals Covered87
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $42,042
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,188,869
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $42,042
    Insurance broker organization code?3
    Insurance broker nameJANET L HORSTMAN
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
    Policy contract number0848103HNO
    Policy instance 5
    Insurance contract or identification number0848103HNO
    Number of Individuals Covered76
    Insurance policy start date2014-09-01
    Insurance policy end date2015-08-31
    Total amount of commissions paid to insurance brokerUSD $33,385
    Total amount of fees paid to insurance companyUSD $98
    Welfare Benefit Premiums Paid to CarrierUSD $528,595
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Amount paid for insurance broker fees98
    Additional information about fees paid to insurance brokerELIGIBLE INDIRECT COMPENSATION
    Commission paid to Insurance BrokerUSD $33,385
    Insurance broker nameBROWN & BROWN OF PA INC DBA
    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number00305518
    Policy instance 4
    Insurance contract or identification number00305518
    Number of Individuals Covered84
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $1,620
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $12,203
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,612
    Additional information about fees paid to insurance brokerBROKER
    Insurance broker organization code?3
    Insurance broker nameINDEPENDENCE PLANNING GROUP
    HUMANA INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number563846
    Policy instance 3
    Insurance contract or identification number563846
    Number of Individuals Covered65
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $1,114
    Dental Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $18,561
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,114
    Insurance broker organization code?3
    Insurance broker nameMARK T HORSTMAN
    UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
    Policy contract number5473459
    Policy instance 1
    Insurance contract or identification number5473459
    Number of Individuals Covered74
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $2,014
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $21,082
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $2,014
    Insurance broker organization code?3
    Insurance broker nameMARK HORSTMAN
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number401251
    Policy instance 6
    Insurance contract or identification number401251
    Number of Individuals Covered80
    Insurance policy start date2014-06-30
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $22,764
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $593,129
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $15,498
    Insurance broker organization code?3
    Insurance broker nameJANET HORSTMAN
    UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
    Policy contract numberPC 00007096
    Policy instance 1
    Insurance contract or identification numberPC 00007096
    Number of Individuals Covered110
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $1,916
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $21,002
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,916
    Insurance broker organization code?3
    Insurance broker nameMARK HORSTMAN
    HUMANA INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number563846
    Policy instance 2
    Insurance contract or identification number563846
    Number of Individuals Covered69
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $1,029
    Dental Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $17,757
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
    Policy contract number0848103HNO
    Policy instance 4
    Insurance contract or identification number0848103HNO
    Number of Individuals Covered80
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $28,459
    Total amount of fees paid to insurance companyUSD $47
    Welfare Benefit Premiums Paid to CarrierUSD $482,492
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number401251
    Policy instance 7
    Insurance contract or identification number401251
    Number of Individuals Covered80
    Insurance policy start date2014-06-30
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $22,764
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $593,129
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $22,764
    Insurance broker organization code?3
    Insurance broker nameJANET L HORSTMAN
    UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
    Policy contract number007094303
    Policy instance 2
    Insurance contract or identification number007094303
    Number of Individuals Covered11
    Insurance policy start date2014-06-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $1,520
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $40,054
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $1,520
    Insurance broker organization code?3
    Insurance broker nameANDERSON & KIME EMPLOYEE BENEFITS
    HUMANA INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number563846
    Policy instance 3
    Insurance contract or identification number563846
    Number of Individuals Covered69
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $1,029
    Dental Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $17,757
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,029
    Insurance broker organization code?3
    Insurance broker nameMARK T HORSTMAN
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
    Policy contract number0848103HNO
    Policy instance 5
    Insurance contract or identification number0848103HNO
    Number of Individuals Covered80
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $28,459
    Total amount of fees paid to insurance companyUSD $47
    Welfare Benefit Premiums Paid to CarrierUSD $482,492
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Amount paid for insurance broker fees47
    Additional information about fees paid to insurance brokerELIGIBLE INDIRECT COMPENSATION
    Commission paid to Insurance BrokerUSD $28,459
    Insurance broker nameBROWN & BROWN OF PA INC DBA
    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number00305518
    Policy instance 4
    Insurance contract or identification number00305518
    Number of Individuals Covered71
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $1,212
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $8,772
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,206
    Additional information about fees paid to insurance brokerBROKER
    Insurance broker organization code?3
    Insurance broker nameINDEPENDENCE PLANNING GROUP
    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number00305518
    Policy instance 3
    Insurance contract or identification number00305518
    Number of Individuals Covered71
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $1,212
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $8,772
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number401251
    Policy instance 5
    Insurance contract or identification number401251
    Number of Individuals Covered106
    Insurance policy start date2014-01-01
    Insurance policy end date2014-05-31
    Total amount of commissions paid to insurance brokerUSD $15,498
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $379,431
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number401251
    Policy instance 6
    Insurance contract or identification number401251
    Number of Individuals Covered104
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $39,005
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $961,665
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $39,005
    Insurance broker organization code?3
    Insurance broker nameJANET HORSTMAN
    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number00305518
    Policy instance 4
    Insurance contract or identification number00305518
    Number of Individuals Covered61
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $1,059
    Total amount of fees paid to insurance companyUSD $265
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $7,557
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,054
    Amount paid for insurance broker fees265
    Additional information about fees paid to insurance brokerBROKER
    Insurance broker organization code?3
    Insurance broker nameINDEPENDENCE PLANNING GROUP
    HUMANA INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number563846
    Policy instance 3
    Insurance contract or identification number563846
    Number of Individuals Covered63
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $1,128
    Dental Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $18,271
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,128
    Insurance broker organization code?3
    Insurance broker nameMARK T HORSTMAN
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number105157
    Policy instance 2
    Insurance contract or identification number105157
    Number of Individuals Covered75
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $3,661
    Health Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $142,448
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,661
    Insurance broker organization code?3
    Insurance broker nameHARTMAN EMPLOYEE BENEFITS INC
    UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
    Policy contract number7096
    Policy instance 1
    Insurance contract or identification number7096
    Number of Individuals Covered118
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $2,265
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $30,587
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,265
    Insurance broker organization code?3
    Insurance broker nameMARK HORSTMAN
    AETNA (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number848103
    Policy instance 5
    Insurance contract or identification number848103
    Number of Individuals Covered77
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $2,455
    Total amount of fees paid to insurance companyUSD $265
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $37,772
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,455
    Amount paid for insurance broker fees265
    Additional information about fees paid to insurance brokerBROKER
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF PA INC
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number401251
    Policy instance 6
    Insurance contract or identification number401251
    Number of Individuals Covered129
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $38,803
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $970,078
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $38,803
    Insurance broker organization code?3
    Insurance broker nameJANET HORSTMAN
    UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
    Policy contract number7096
    Policy instance 1
    Insurance contract or identification number7096
    Number of Individuals Covered129
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $2,271
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $30,824
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,271
    Insurance broker organization code?3
    Insurance broker nameMARK HORSTMAN
    KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
    Policy contract number0000834512
    Policy instance 5
    Insurance contract or identification number0000834512
    Number of Individuals Covered117
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $19,325
    Health Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $364,017
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $19,325
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF PENNA INC
    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number00305518
    Policy instance 4
    Insurance contract or identification number00305518
    Number of Individuals Covered65
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $1,282
    Total amount of fees paid to insurance companyUSD $37
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $9,380
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,276
    Amount paid for insurance broker fees37
    Additional information about fees paid to insurance brokerBROKER
    Insurance broker organization code?3
    Insurance broker nameINDEPENDENCE PLANNING GROUP
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number563846
    Policy instance 3
    Insurance contract or identification number563846
    Number of Individuals Covered70
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $1,105
    Dental Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $18,880
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,105
    Insurance broker organization code?3
    Insurance broker nameMARK T HORSTMAN
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number105157
    Policy instance 2
    Insurance contract or identification number105157
    Number of Individuals Covered74
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $11,773
    Health Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $328,914
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $11,773
    Insurance broker organization code?3
    Insurance broker nameHARTMAN EMPLOYEE BENEFITS INC
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number105157
    Policy instance 2
    Insurance contract or identification number105157
    Number of Individuals Covered59
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $12,672
    Health Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $316,792
    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 number563846
    Policy instance 3
    Insurance contract or identification number563846
    Number of Individuals Covered66
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $1,384
    Dental Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $18,541
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number00305518
    Policy instance 4
    Insurance contract or identification number00305518
    Number of Individuals Covered71
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $1,305
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $9,612
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number401251
    Policy instance 6
    Insurance contract or identification number401251
    Number of Individuals Covered120
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $39,242
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $981,040
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
    Policy contract number0000834512
    Policy instance 5
    Insurance contract or identification number0000834512
    Number of Individuals Covered146
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $23,562
    Total amount of fees paid to insurance companyUSD $776
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $497,528
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
    Policy contract number7096
    Policy instance 1
    Insurance contract or identification number7096
    Number of Individuals Covered141
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $2,224
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $28,968
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number401251
    Policy instance 6
    Insurance contract or identification number401251
    Number of Individuals Covered135
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $38,272
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $956,795
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
    Policy contract number0000834512
    Policy instance 5
    Insurance contract or identification number0000834512
    Number of Individuals Covered62
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $22,872
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $415,861
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number00305518
    Policy instance 4
    Insurance contract or identification number00305518
    Number of Individuals Covered81
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $1,565
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $11,753
    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 number563846
    Policy instance 3
    Insurance contract or identification number563846
    Number of Individuals Covered76
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $1,568
    Dental Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $18,827
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
    Policy contract number7096
    Policy instance 1
    Insurance contract or identification number7096
    Number of Individuals Covered155
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $2,264
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $30,564
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number105157
    Policy instance 2
    Insurance contract or identification number105157
    Number of Individuals Covered64
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $13,436
    Health Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $328,214
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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