HOLLAND ROOFING, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HOLLAND ROOFING WELFARE BENEFIT PLAN
Measure | Date | Value |
---|
2022: HOLLAND ROOFING WELFARE BENEFIT PLAN 2022 401k membership |
---|
Total participants, beginning-of-year | 2022-01-01 | 200 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 215 |
Total of all active and inactive participants | 2022-01-01 | 215 |
2021: HOLLAND ROOFING WELFARE BENEFIT PLAN 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-01-01 | 194 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 196 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 4 |
Total of all active and inactive participants | 2021-01-01 | 200 |
2020: HOLLAND ROOFING WELFARE BENEFIT PLAN 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-01-01 | 205 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 190 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 4 |
Total of all active and inactive participants | 2020-01-01 | 194 |
2019: HOLLAND ROOFING WELFARE BENEFIT PLAN 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-01-01 | 197 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 204 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 1 |
Total of all active and inactive participants | 2019-01-01 | 205 |
2018: HOLLAND ROOFING WELFARE BENEFIT PLAN 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-01-01 | 189 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 196 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 1 |
Total of all active and inactive participants | 2018-01-01 | 197 |
2017: HOLLAND ROOFING WELFARE BENEFIT PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-01-01 | 214 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 189 |
Total of all active and inactive participants | 2017-01-01 | 189 |
Total participants | 2017-01-01 | 189 |
2016: HOLLAND ROOFING WELFARE BENEFIT PLAN 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-01-01 | 195 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 214 |
Total of all active and inactive participants | 2016-01-01 | 214 |
Total participants | 2016-01-01 | 214 |
2015: HOLLAND ROOFING WELFARE BENEFIT PLAN 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-01-01 | 146 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 128 |
Total of all active and inactive participants | 2015-01-01 | 128 |
Total participants | 2015-01-01 | 128 |
2014: HOLLAND ROOFING WELFARE BENEFIT PLAN 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-01-01 | 141 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 146 |
Total of all active and inactive participants | 2014-01-01 | 146 |
Total participants | 2014-01-01 | 146 |
2013: HOLLAND ROOFING WELFARE BENEFIT PLAN 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-01-01 | 158 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 141 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 141 |
2012: HOLLAND ROOFING WELFARE BENEFIT PLAN 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-01-01 | 160 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 158 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 158 |
2011: HOLLAND ROOFING WELFARE BENEFIT PLAN 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-01-01 | 181 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 160 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
Total of all active and inactive participants | 2011-01-01 | 160 |
2022: HOLLAND ROOFING WELFARE BENEFIT PLAN 2022 form 5500 responses |
---|
2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: HOLLAND ROOFING WELFARE BENEFIT PLAN 2021 form 5500 responses |
---|
2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: HOLLAND ROOFING WELFARE BENEFIT PLAN 2020 form 5500 responses |
---|
2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: HOLLAND ROOFING WELFARE BENEFIT PLAN 2019 form 5500 responses |
---|
2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: HOLLAND ROOFING WELFARE BENEFIT PLAN 2018 form 5500 responses |
---|
2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: HOLLAND ROOFING WELFARE BENEFIT PLAN 2017 form 5500 responses |
---|
2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: HOLLAND ROOFING WELFARE BENEFIT PLAN 2016 form 5500 responses |
---|
2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: HOLLAND ROOFING WELFARE BENEFIT PLAN 2015 form 5500 responses |
---|
2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: HOLLAND ROOFING WELFARE BENEFIT PLAN 2014 form 5500 responses |
---|
2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: HOLLAND ROOFING WELFARE BENEFIT PLAN 2013 form 5500 responses |
---|
2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | Yes |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: HOLLAND ROOFING WELFARE BENEFIT PLAN 2012 form 5500 responses |
---|
2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Submission has been amended | Yes |
2012-01-01 | This submission is the final filing | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-01-01 | Plan is a collectively bargained plan | No |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2011: HOLLAND ROOFING WELFARE BENEFIT PLAN 2011 form 5500 responses |
---|
2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Submission has been amended | Yes |
2011-01-01 | This submission is the final filing | No |
2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-01-01 | Plan is a collectively bargained plan | No |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 08L6473 |
Policy instance | 5 |
Insurance contract or identification number | 08L6473 | Number of Individuals Covered | 12 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,584 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HRA | Welfare Benefit Premiums Paid to Carrier | USD $80,080 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,584 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 4 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 291 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,090 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER. CI, ACC, DIS | Welfare Benefit Premiums Paid to Carrier | USD $93,660 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,239 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 ) |
Policy contract number | 71343V |
Policy instance | 3 |
Insurance contract or identification number | 71343V | Number of Individuals Covered | 272 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,921 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,921 | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | EL108-2006-21 |
Policy instance | 2 |
Insurance contract or identification number | EL108-2006-21 | Number of Individuals Covered | 0 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $300,022 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 ) |
Policy contract number | 0713430 |
Policy instance | 1 |
Insurance contract or identification number | 0713430 | Number of Individuals Covered | 312 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,543 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,543 | Insurance broker organization code? | 3 |
|
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
Policy contract number | 080715 |
Policy instance | 1 |
Insurance contract or identification number | 080715 | Number of Individuals Covered | 322 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $2,105 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $83,217 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,105 | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | EL108-2006-21 |
Policy instance | 2 |
Insurance contract or identification number | EL108-2006-21 | Number of Individuals Covered | 196 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $286,987 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | W27033 |
Policy instance | 3 |
Insurance contract or identification number | W27033 | Number of Individuals Covered | 283 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $2,039 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,419 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,039 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 4 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 121 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $5,054 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER. CI, ACC, DIS | Welfare Benefit Premiums Paid to Carrier | USD $51,651 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,562 | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 08L6473 |
Policy instance | 5 |
Insurance contract or identification number | 08L6473 | Number of Individuals Covered | 11 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,809 | Total amount of fees paid to insurance company | USD $237 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HRA | Welfare Benefit Premiums Paid to Carrier | USD $65,229 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,809 | Amount paid for insurance broker fees | 237 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
Policy contract number | 080715 |
Policy instance | 1 |
Insurance contract or identification number | 080715 | Number of Individuals Covered | 316 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,350 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $75,437 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,350 | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | EL108-2006-19 |
Policy instance | 2 |
Insurance contract or identification number | EL108-2006-19 | Number of Individuals Covered | 190 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $287,975 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | W27033 |
Policy instance | 3 |
Insurance contract or identification number | W27033 | Number of Individuals Covered | 261 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,946 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,890 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,946 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 4 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 143 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $6,385 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER, CI, ACC, DIS | Welfare Benefit Premiums Paid to Carrier | USD $61,231 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,558 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 5 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 156 | Total amount of commissions paid to insurance broker | USD $6,599 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER, CI, ACC, DIS | Welfare Benefit Premiums Paid to Carrier | USD $66,225 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,523 | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 00X9159 |
Policy instance | 4 |
Insurance contract or identification number | 00X9159 | Number of Individuals Covered | 3 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $205 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HRA | Welfare Benefit Premiums Paid to Carrier | USD $37,353 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $205 | Insurance broker organization code? | 3 |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 001108908 |
Policy instance | 3 |
Insurance contract or identification number | 001108908 | Number of Individuals Covered | 273 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,840 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,974 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,840 | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | EL108-2006-19 |
Policy instance | 2 |
Insurance contract or identification number | EL108-2006-19 | Number of Individuals Covered | 204 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $319,436 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
Policy contract number | VARIOUS |
Policy instance | 1 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 321 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,744 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $87,719 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,744 | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 00X9159 |
Policy instance | 6 |
Insurance contract or identification number | 00X9159 | Number of Individuals Covered | 4 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,440 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HRA | Welfare Benefit Premiums Paid to Carrier | USD $57,765 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,440 | Insurance broker organization code? | 3 |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 001108908 |
Policy instance | 5 |
Insurance contract or identification number | 001108908 | Number of Individuals Covered | 239 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,556 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,029 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,556 | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | EL108-2003-18 |
Policy instance | 4 |
Insurance contract or identification number | EL108-2003-18 | Number of Individuals Covered | 196 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $284,711 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
Policy contract number | 04695801 |
Policy instance | 3 |
Insurance contract or identification number | 04695801 | Number of Individuals Covered | 163 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $2,362 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,607 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,362 | Insurance broker organization code? | 3 |
|
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
Policy contract number | 04695201 |
Policy instance | 2 |
Insurance contract or identification number | 04695201 | Number of Individuals Covered | 119 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,416 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,717 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,416 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 1 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 162 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $8,016 | Other welfare benefits provided | ACCIDENT, CANCER, TERM LIFE | Welfare Benefit Premiums Paid to Carrier | USD $76,772 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,383 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 1 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 194 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $15,151 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $87,618 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,210 | Insurance broker organization code? | 3 | Insurance broker name | JAMES L TUEMLER |
|
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
Policy contract number | 04695201 |
Policy instance | 2 |
Insurance contract or identification number | 04695201 | Number of Individuals Covered | 105 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,657 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,027 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,657 | Insurance broker organization code? | 3 | Insurance broker name | LANG FINANCIAL |
|
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
Policy contract number | 04695801 |
Policy instance | 3 |
Insurance contract or identification number | 04695801 | Number of Individuals Covered | 132 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,196 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,245 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,196 | Insurance broker organization code? | 3 | Insurance broker name | LANG FINANCIAL |
|
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
Policy contract number | NUTA-1411-B |
Policy instance | 4 |
Insurance contract or identification number | NUTA-1411-B | Number of Individuals Covered | 189 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $34,188 | Welfare Benefit Premiums Paid to Carrier | USD $245,629 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,188 | Insurance broker organization code? | 3 | Insurance broker name | LANG FINANCIAL GROUP, INC. |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 001108908 |
Policy instance | 5 |
Insurance contract or identification number | 001108908 | Number of Individuals Covered | 206 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,636 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,377 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,636 | Insurance broker organization code? | 3 | Insurance broker name | LANG FINANCIAL GROUP, INC. |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 00X9159 |
Policy instance | 6 |
Insurance contract or identification number | 00X9159 | Number of Individuals Covered | 6 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,387 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HRA | Welfare Benefit Premiums Paid to Carrier | USD $74,761 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,387 | Insurance broker organization code? | 3 | Insurance broker name | LANG FINANCIAL GROUP, INC. |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 1 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 111 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $12,346 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $66,706 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,247 | Insurance broker organization code? | 3 | Insurance broker name | NAPIER MARKETING CORP |
|
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
Policy contract number | 04695801 |
Policy instance | 4 |
Insurance contract or identification number | 04695801 | Number of Individuals Covered | 86 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,054 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,004 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,054 | Insurance broker organization code? | 3 | Insurance broker name | LANG FINANCIAL |
|
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
Policy contract number | 04695201 |
Policy instance | 3 |
Insurance contract or identification number | 04695201 | Number of Individuals Covered | 88 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,013 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,181 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,013 | Insurance broker organization code? | 3 | Insurance broker name | LANG FINANCIAL |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 00240971 |
Policy instance | 2 |
Insurance contract or identification number | 00240971 | Number of Individuals Covered | 335 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $215,178 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 1 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 133 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $8,015 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $70,118 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,200 | Insurance broker organization code? | 3 | Insurance broker name | NAPIER MARKETING CORP |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 00240971 |
Policy instance | 2 |
Insurance contract or identification number | 00240971 | Number of Individuals Covered | 203 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $10,450 | Welfare Benefit Premiums Paid to Carrier | USD $142,749 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,450 | Insurance broker name | LANG FINANCIAL GROUP INC |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 1 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 141 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $11,133 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SPECIFIC ILLNESS, ACCIDENT, CANCER | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $78,271 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,744 | Insurance broker organization code? | 3 | Insurance broker name | JAMES TUEMIER |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 730862 |
Policy instance | 2 |
Insurance contract or identification number | 730862 | Number of Individuals Covered | 258 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,126 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $926,195 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,126 | Insurance broker organization code? | 3 | Insurance broker name | LANG FINANCIAL GROUP, INC. |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 730862 |
Policy instance | 2 |
Insurance contract or identification number | 730862 | Number of Individuals Covered | 273 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $18,787 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $936,655 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,787 | Insurance broker organization code? | 3 | Insurance broker name | PHILIPPO INSURANCE AGENCY, LLC |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 1 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 158 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $18,469 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SPECIFIC ILLNESS, ACCIDENT, CANCER | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $87,519 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,166 | Insurance broker organization code? | 3 | Insurance broker name | JAMES TUEMIER |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 730862 |
Policy instance | 2 |
Insurance contract or identification number | 730862 | Number of Individuals Covered | 343 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $21,282 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $982,289 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | VARIOUS |
Policy instance | 1 |
Insurance contract or identification number | VARIOUS | Number of Individuals Covered | 160 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $14,807 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SPECIFIC ILLNESS, ACCIDENT, CANCER | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $78,963 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|