WEST COAST TURF has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN
401k plan membership statisitcs for WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN
Measure | Date | Value |
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2022: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-02-01 | 198 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 188 |
Number of retired or separated participants receiving benefits | 2022-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-02-01 | 0 |
Total of all active and inactive participants | 2022-02-01 | 188 |
2021: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-02-01 | 198 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 188 |
Number of retired or separated participants receiving benefits | 2021-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-02-01 | 0 |
Total of all active and inactive participants | 2021-02-01 | 188 |
2020: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-02-01 | 206 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 202 |
Total of all active and inactive participants | 2020-02-01 | 202 |
2019: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-02-01 | 223 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 206 |
Total of all active and inactive participants | 2019-02-01 | 206 |
2018: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-02-01 | 202 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 225 |
Total of all active and inactive participants | 2018-02-01 | 225 |
2017: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-02-01 | 180 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 205 |
Number of retired or separated participants receiving benefits | 2017-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-02-01 | 0 |
Total of all active and inactive participants | 2017-02-01 | 205 |
2016: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-02-01 | 216 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 180 |
Total of all active and inactive participants | 2016-02-01 | 180 |
2015: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-02-01 | 204 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 192 |
Number of retired or separated participants receiving benefits | 2015-02-01 | 1 |
Total of all active and inactive participants | 2015-02-01 | 193 |
2014: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-02-01 | 183 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 204 |
Number of retired or separated participants receiving benefits | 2014-02-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2014-02-01 | 0 |
Total of all active and inactive participants | 2014-02-01 | 205 |
2013: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-02-01 | 131 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 183 |
Number of retired or separated participants receiving benefits | 2013-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-02-01 | 0 |
Total of all active and inactive participants | 2013-02-01 | 183 |
2012: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-02-01 | 184 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 131 |
Number of retired or separated participants receiving benefits | 2012-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-02-01 | 0 |
Total of all active and inactive participants | 2012-02-01 | 131 |
2011: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-02-01 | 196 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 184 |
Number of retired or separated participants receiving benefits | 2011-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-02-01 | 0 |
Total of all active and inactive participants | 2011-02-01 | 184 |
2009: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-02-01 | 260 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-02-01 | 195 |
Number of retired or separated participants receiving benefits | 2009-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-02-01 | 0 |
Total of all active and inactive participants | 2009-02-01 | 195 |
Total participants | 2009-02-01 | 0 |
2008: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2008 401k membership |
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Total participants, beginning-of-year | 2008-02-01 | 334 |
Total number of active participants reported on line 7a of the Form 5500 | 2008-02-01 | 260 |
Number of retired or separated participants receiving benefits | 2008-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2008-02-01 | 0 |
Total of all active and inactive participants | 2008-02-01 | 260 |
2007: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2007 401k membership |
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Total participants, beginning-of-year | 2007-02-01 | 350 |
Total number of active participants reported on line 7a of the Form 5500 | 2007-02-01 | 334 |
Number of retired or separated participants receiving benefits | 2007-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2007-02-01 | 0 |
Total of all active and inactive participants | 2007-02-01 | 334 |
2006: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2006 401k membership |
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Total participants, beginning-of-year | 2006-02-01 | 315 |
Total number of active participants reported on line 7a of the Form 5500 | 2006-02-01 | 350 |
Number of retired or separated participants receiving benefits | 2006-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2006-02-01 | 0 |
Total of all active and inactive participants | 2006-02-01 | 350 |
2005: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2005 401k membership |
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Total participants, beginning-of-year | 2005-02-01 | 309 |
Total number of active participants reported on line 7a of the Form 5500 | 2005-02-01 | 315 |
Number of retired or separated participants receiving benefits | 2005-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2005-02-01 | 0 |
Total of all active and inactive participants | 2005-02-01 | 315 |
2004: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2004 401k membership |
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Total participants, beginning-of-year | 2004-02-01 | 343 |
Total number of active participants reported on line 7a of the Form 5500 | 2004-02-01 | 309 |
Number of retired or separated participants receiving benefits | 2004-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2004-02-01 | 0 |
Total of all active and inactive participants | 2004-02-01 | 309 |
2022: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2022 form 5500 responses |
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2022-02-01 | Type of plan entity | Single employer plan |
2022-02-01 | Submission has been amended | No |
2022-02-01 | This submission is the final filing | No |
2022-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-02-01 | Plan is a collectively bargained plan | No |
2022-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-02-01 | Plan benefit arrangement – Insurance | Yes |
2022-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2021 form 5500 responses |
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2021-02-01 | Type of plan entity | Single employer plan |
2021-02-01 | Submission has been amended | Yes |
2021-02-01 | This submission is the final filing | No |
2021-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-02-01 | Plan is a collectively bargained plan | No |
2021-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-02-01 | Plan benefit arrangement – Insurance | Yes |
2021-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2020 form 5500 responses |
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2020-02-01 | Type of plan entity | Single employer plan |
2020-02-01 | Submission has been amended | No |
2020-02-01 | This submission is the final filing | No |
2020-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-02-01 | Plan is a collectively bargained plan | No |
2020-02-01 | Plan funding arrangement – Insurance | Yes |
2020-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-02-01 | Plan benefit arrangement – Insurance | Yes |
2020-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2019 form 5500 responses |
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2019-02-01 | Type of plan entity | Single employer plan |
2019-02-01 | Submission has been amended | No |
2019-02-01 | This submission is the final filing | No |
2019-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-02-01 | Plan is a collectively bargained plan | No |
2019-02-01 | Plan funding arrangement – Insurance | Yes |
2019-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-02-01 | Plan benefit arrangement – Insurance | Yes |
2019-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2018 form 5500 responses |
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2018-02-01 | Type of plan entity | Single employer plan |
2018-02-01 | Submission has been amended | No |
2018-02-01 | This submission is the final filing | No |
2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-02-01 | Plan is a collectively bargained plan | No |
2018-02-01 | Plan funding arrangement – Insurance | Yes |
2018-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-02-01 | Plan benefit arrangement – Insurance | Yes |
2018-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2017 form 5500 responses |
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2017-02-01 | Type of plan entity | Single employer plan |
2017-02-01 | Submission has been amended | No |
2017-02-01 | This submission is the final filing | No |
2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-02-01 | Plan is a collectively bargained plan | No |
2017-02-01 | Plan funding arrangement – Insurance | Yes |
2017-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-02-01 | Plan benefit arrangement – Insurance | Yes |
2017-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2016 form 5500 responses |
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2016-02-01 | Type of plan entity | Single employer plan |
2016-02-01 | Submission has been amended | No |
2016-02-01 | This submission is the final filing | No |
2016-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-02-01 | Plan is a collectively bargained plan | No |
2016-02-01 | Plan funding arrangement – Insurance | Yes |
2016-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-02-01 | Plan benefit arrangement – Insurance | Yes |
2016-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2015 form 5500 responses |
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2015-02-01 | Type of plan entity | Single employer plan |
2015-02-01 | Submission has been amended | No |
2015-02-01 | This submission is the final filing | No |
2015-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-02-01 | Plan is a collectively bargained plan | No |
2015-02-01 | Plan funding arrangement – Insurance | Yes |
2015-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-02-01 | Plan benefit arrangement – Insurance | Yes |
2015-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2014 form 5500 responses |
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2014-02-01 | Type of plan entity | Single employer plan |
2014-02-01 | Submission has been amended | No |
2014-02-01 | This submission is the final filing | No |
2014-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-02-01 | Plan is a collectively bargained plan | No |
2014-02-01 | Plan funding arrangement – Insurance | Yes |
2014-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-02-01 | Plan benefit arrangement – Insurance | Yes |
2014-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2013 form 5500 responses |
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2013-02-01 | Type of plan entity | Single employer plan |
2013-02-01 | Submission has been amended | No |
2013-02-01 | This submission is the final filing | No |
2013-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-02-01 | Plan is a collectively bargained plan | No |
2013-02-01 | Plan funding arrangement – Insurance | Yes |
2013-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-02-01 | Plan benefit arrangement – Insurance | Yes |
2013-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2012 form 5500 responses |
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2012-02-01 | Type of plan entity | Single employer plan |
2012-02-01 | Submission has been amended | No |
2012-02-01 | This submission is the final filing | No |
2012-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-02-01 | Plan is a collectively bargained plan | No |
2012-02-01 | Plan funding arrangement – Insurance | Yes |
2012-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-02-01 | Plan benefit arrangement – Insurance | Yes |
2012-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2011 form 5500 responses |
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2011-02-01 | Type of plan entity | Single employer plan |
2011-02-01 | Submission has been amended | No |
2011-02-01 | This submission is the final filing | No |
2011-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-02-01 | Plan is a collectively bargained plan | No |
2011-02-01 | Plan funding arrangement – Insurance | Yes |
2011-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-02-01 | Plan benefit arrangement – Insurance | Yes |
2011-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2009 form 5500 responses |
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2009-02-01 | Type of plan entity | Single employer plan |
2009-02-01 | Submission has been amended | No |
2009-02-01 | This submission is the final filing | No |
2009-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-02-01 | Plan is a collectively bargained plan | No |
2009-02-01 | Plan funding arrangement – Insurance | Yes |
2009-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-02-01 | Plan benefit arrangement – Insurance | Yes |
2009-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2008: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2008 form 5500 responses |
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2008-02-01 | Type of plan entity | Single employer plan |
2008-02-01 | Submission has been amended | No |
2008-02-01 | This submission is the final filing | No |
2008-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2008-02-01 | Plan is a collectively bargained plan | No |
2008-02-01 | Plan funding arrangement – Insurance | Yes |
2008-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2008-02-01 | Plan benefit arrangement – Insurance | Yes |
2008-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2007: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2007 form 5500 responses |
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2007-02-01 | Type of plan entity | Single employer plan |
2007-02-01 | Submission has been amended | No |
2007-02-01 | This submission is the final filing | No |
2007-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2007-02-01 | Plan is a collectively bargained plan | No |
2007-02-01 | Plan funding arrangement – Insurance | Yes |
2007-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2007-02-01 | Plan benefit arrangement – Insurance | Yes |
2007-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2006: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2006 form 5500 responses |
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2006-02-01 | Type of plan entity | Single employer plan |
2006-02-01 | Submission has been amended | No |
2006-02-01 | This submission is the final filing | No |
2006-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2006-02-01 | Plan is a collectively bargained plan | No |
2006-02-01 | Plan funding arrangement – Insurance | Yes |
2006-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2006-02-01 | Plan benefit arrangement – Insurance | Yes |
2006-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2005: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2005 form 5500 responses |
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2005-02-01 | Type of plan entity | Single employer plan |
2005-02-01 | Submission has been amended | No |
2005-02-01 | This submission is the final filing | No |
2005-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2005-02-01 | Plan is a collectively bargained plan | No |
2005-02-01 | Plan funding arrangement – Insurance | Yes |
2005-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2005-02-01 | Plan benefit arrangement – Insurance | Yes |
2005-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2004: WEST COAST TURF HEALTH & WELFARE BENEFIT PLAN 2004 form 5500 responses |
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2004-02-01 | Type of plan entity | Single employer plan |
2004-02-01 | Submission has been amended | No |
2004-02-01 | This submission is the final filing | No |
2004-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2004-02-01 | Plan is a collectively bargained plan | No |
2004-02-01 | Plan funding arrangement – Insurance | Yes |
2004-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2004-02-01 | Plan benefit arrangement – Insurance | Yes |
2004-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00558780 |
Policy instance | 2 |
Insurance contract or identification number | 00558780 | Number of Individuals Covered | 188 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $14,611 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY LIFE AND VOLUNTARY AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $73,948 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,611 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | 0 | Insurance broker organization code? | 3 |
|
CALIFORNIACHOICE (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | 55069, 55060 |
Policy instance | 1 |
Insurance contract or identification number | 55069, 55060 | Number of Individuals Covered | 112 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $56,384 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,127,740 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $56,384 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | 0 | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 01X9807 |
Policy instance | 3 |
Insurance contract or identification number | 01X9807 | Number of Individuals Covered | 48 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $9,669 | Total amount of fees paid to insurance company | USD $0 | 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 $265,110 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,446 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | 0 | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 01X9807 |
Policy instance | 6 |
Insurance contract or identification number | 01X9807 | Number of Individuals Covered | 56 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $11,253 | Total amount of fees paid to insurance company | USD $0 | 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 $308,922 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,502 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00558780 |
Policy instance | 2 |
Insurance contract or identification number | 00558780 | Number of Individuals Covered | 188 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $14,190 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, VOLUNTARY LIFE AND VOLUNTARY AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $70,211 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,190 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 01X9807 |
Policy instance | 5 |
Insurance contract or identification number | 01X9807 | Number of Individuals Covered | 57 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $12,243 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $321,239 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,081 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00558780 |
Policy instance | 2 |
Insurance contract or identification number | 00558780 | Number of Individuals Covered | 196 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $15,185 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, VOLUNTARY LIFE, VOLUNTARY AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $71,624 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,185 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00558780 |
Policy instance | 2 |
Insurance contract or identification number | 00558780 | Number of Individuals Covered | 203 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $14,975 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, OPTIONAL AD&D, OPTIONAL LIFE | 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 $70,788 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $14,975 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 1X9807 |
Policy instance | 6 |
Insurance contract or identification number | 1X9807 | Number of Individuals Covered | 77 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $14,520 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $382,849 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,680 | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1062019 |
Policy instance | 4 |
Insurance contract or identification number | 1062019 | Number of Individuals Covered | 469 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $3,262 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | 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 $21,919 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,262 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES INSURANCE |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 5 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 38 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $727 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | 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 $6,378 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $727 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOC INS SRVCS |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 01X9807 |
Policy instance | 6 |
Insurance contract or identification number | 01X9807 | Number of Individuals Covered | 96 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $18,384 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $406,411 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,605 | Insurance broker organization code? | 3 | Insurance broker name | GEORGE EKIZIAN |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00357696 |
Policy instance | 1 |
Insurance contract or identification number | 00357696 | Number of Individuals Covered | 192 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $524 | 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 | AD&D, DEP. LIFE | 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 $10,489 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $524 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES INSURANCE |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 2 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 42 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $660 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $660 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOCIATES |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 357696 |
Policy instance | 1 |
Insurance contract or identification number | 357696 | Number of Individuals Covered | 204 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $530 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $10,606 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $530 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOCIATES |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H26723 |
Policy instance | 3 |
Insurance contract or identification number | H26723 | Number of Individuals Covered | 25 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $996 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $996 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $996 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOCIATES |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 2 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 41 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $692 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,964 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $692 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOCIATES |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P79555 & H26723 |
Policy instance | 3 |
Insurance contract or identification number | P79555 & H26723 | Number of Individuals Covered | 108 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $1,310 | Total amount of fees paid to insurance company | USD $46 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,483 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,310 | Amount paid for insurance broker fees | 46 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOCIATES |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 357696 |
Policy instance | 1 |
Insurance contract or identification number | 357696 | Number of Individuals Covered | 183 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $398 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $7,949 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $398 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOCIATES |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 357696 |
Policy instance | 1 |
Insurance contract or identification number | 357696 | Number of Individuals Covered | 138 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $313 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $6,257 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $313 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOCIATES |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P79555 & H26723 |
Policy instance | 4 |
Insurance contract or identification number | P79555 & H26723 | Number of Individuals Covered | 109 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $1,440 | Total amount of fees paid to insurance company | USD $80 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,955 | 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 | Amount paid for insurance broker fees | 80 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOCIATES |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 3 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 43 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $685 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $685 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN AND ASSOCIATES |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 350005 |
Policy instance | 2 |
Insurance contract or identification number | 350005 | Number of Individuals Covered | 45 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2012-07-31 | Total amount of commissions paid to insurance broker | USD $25,791 | Total amount of fees paid to insurance company | USD $12,895 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $370,565 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,791 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 12895 | Additional information about fees paid to insurance broker | BONUSES, OVERRIDES, OR OTHER FEES | Insurance broker name | LISI, INC. |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 3 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 46 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $743 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 350005 |
Policy instance | 2 |
Insurance contract or identification number | 350005 | Number of Individuals Covered | 45 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2011-07-31 | Total amount of commissions paid to insurance broker | USD $23,954 | Total amount of fees paid to insurance company | USD $11,977 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $342,612 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 357696 |
Policy instance | 1 |
Insurance contract or identification number | 357696 | Number of Individuals Covered | 147 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $332 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $6,646 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P79555 & H26723 |
Policy instance | 4 |
Insurance contract or identification number | P79555 & H26723 | Number of Individuals Covered | 106 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $1,152 | Total amount of fees paid to insurance company | USD $80 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,303 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 357696 |
Policy instance | 1 |
Insurance contract or identification number | 357696 | Number of Individuals Covered | 151 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $368 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $6,988 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 350005 |
Policy instance | 2 |
Insurance contract or identification number | 350005 | Number of Individuals Covered | 45 | Insurance policy start date | 2009-08-01 | Insurance policy end date | 2010-07-31 | Total amount of commissions paid to insurance broker | USD $23,085 | Total amount of fees paid to insurance company | USD $11,542 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $327,533 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 3 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 57 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $958 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P79555 & H26723 |
Policy instance | 4 |
Insurance contract or identification number | P79555 & H26723 | Number of Individuals Covered | 66 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $1,272 | Total amount of fees paid to insurance company | USD $89 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,165 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
Policy contract number | 357696 |
Policy instance | 1 |
Insurance contract or identification number | 357696 | Number of Individuals Covered | 323 | Insurance policy start date | 2008-02-01 | Insurance policy end date | 2009-01-31 | Total amount of commissions paid to insurance broker | USD $684 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $13,689 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $684 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P79555 & H26723 |
Policy instance | 4 |
Insurance contract or identification number | P79555 & H26723 | Number of Individuals Covered | 79 | Insurance policy start date | 2008-02-01 | Insurance policy end date | 2009-01-31 | Total amount of commissions paid to insurance broker | USD $1,422 | Total amount of fees paid to insurance company | USD $121 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,422 | Amount paid for insurance broker fees | 121 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 350005 |
Policy instance | 3 |
Insurance contract or identification number | 350005 | Number of Individuals Covered | 45 | Insurance policy start date | 2007-08-01 | Insurance policy end date | 2008-07-31 | Total amount of commissions paid to insurance broker | USD $25,482 | Total amount of fees paid to insurance company | USD $12,741 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $351,281 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,482 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 12741 | Additional information about fees paid to insurance broker | BONUSES, OVERRIDES, OR OTHER FEES | Insurance broker name | LISI, INC. |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 2 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 91 | Insurance policy start date | 2008-02-01 | Insurance policy end date | 2009-01-31 | Total amount of commissions paid to insurance broker | USD $1,303 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,303 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
|
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
Policy contract number | 357696 |
Policy instance | 3 |
Insurance contract or identification number | 357696 | Number of Individuals Covered | 323 | Insurance policy start date | 2007-02-01 | Insurance policy end date | 2008-01-31 | Total amount of commissions paid to insurance broker | USD $614 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $12,271 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $614 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 1 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 112 | Insurance policy start date | 2007-02-01 | Insurance policy end date | 2008-01-31 | Total amount of commissions paid to insurance broker | USD $1,249 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,249 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P79555 & H26723 |
Policy instance | 4 |
Insurance contract or identification number | P79555 & H26723 | Number of Individuals Covered | 76 | Insurance policy start date | 2007-02-01 | Insurance policy end date | 2008-01-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,197 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,404 | Amount paid for insurance broker fees | 84 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 350005 |
Policy instance | 2 |
Insurance contract or identification number | 350005 | Number of Individuals Covered | 45 | Insurance policy start date | 2006-08-01 | Insurance policy end date | 2007-07-31 | Total amount of commissions paid to insurance broker | USD $29,877 | Total amount of fees paid to insurance company | USD $14,939 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $435,706 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,877 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 14939 | Additional information about fees paid to insurance broker | BONUSES, OVERRIDES, OR OTHER FEES | Insurance broker name | LISI, INC. |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 350005 |
Policy instance | 4 |
Insurance contract or identification number | 350005 | Number of Individuals Covered | 45 | Insurance policy start date | 2005-08-01 | Insurance policy end date | 2006-07-31 | Total amount of commissions paid to insurance broker | USD $24,272 | Total amount of fees paid to insurance company | USD $2,157 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $350,566 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,313 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2157 | Additional information about fees paid to insurance broker | BONUSES, OVERRIDES, OR OTHER FEES | Insurance broker name | LISI, INC. |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P79555 & H26723 |
Policy instance | 3 |
Insurance contract or identification number | P79555 & H26723 | Number of Individuals Covered | 78 | Insurance policy start date | 2006-02-01 | Insurance policy end date | 2007-01-31 | Total amount of commissions paid to insurance broker | USD $3,972 | Total amount of fees paid to insurance company | USD $1,518 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $81,328 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,972 | Amount paid for insurance broker fees | 1518 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 2 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 93 | Insurance policy start date | 2006-02-01 | Insurance policy end date | 2007-01-31 | Total amount of commissions paid to insurance broker | USD $1,348 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,348 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
Policy contract number | 357696 |
Policy instance | 1 |
Insurance contract or identification number | 357696 | Number of Individuals Covered | 323 | Insurance policy start date | 2006-02-01 | Insurance policy end date | 2007-01-31 | Total amount of commissions paid to insurance broker | USD $901 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $18,026 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $901 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 350005 |
Policy instance | 1 |
Insurance contract or identification number | 350005 | Number of Individuals Covered | 45 | Insurance policy start date | 2004-08-01 | Insurance policy end date | 2005-07-31 | Total amount of commissions paid to insurance broker | USD $21,285 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $322,090 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,285 | Insurance broker organization code? | 3 | Insurance broker name | LISI, INC. |
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GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
Policy contract number | 357696 |
Policy instance | 2 |
Insurance contract or identification number | 357696 | Number of Individuals Covered | 323 | Insurance policy start date | 2005-02-01 | Insurance policy end date | 2006-01-31 | Total amount of commissions paid to insurance broker | USD $981 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $19,614 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $981 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139883 |
Policy instance | 3 |
Insurance contract or identification number | 139883 | Number of Individuals Covered | 92 | Insurance policy start date | 2005-11-01 | Insurance policy end date | 2006-01-31 | Total amount of commissions paid to insurance broker | USD $165 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,100 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $165 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P79555 & H26723 |
Policy instance | 4 |
Insurance contract or identification number | P79555 & H26723 | Number of Individuals Covered | 214 | Insurance policy start date | 2005-02-01 | Insurance policy end date | 2006-01-31 | Total amount of commissions paid to insurance broker | USD $6,971 | Total amount of fees paid to insurance company | USD $2,622 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $133,138 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,971 | Amount paid for insurance broker fees | 2622 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P79555 |
Policy instance | 2 |
Insurance contract or identification number | P79555 | Number of Individuals Covered | 186 | Insurance policy start date | 2005-02-01 | Insurance policy end date | 2005-01-31 | Total amount of commissions paid to insurance broker | USD $9,072 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $130,224 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,072 | Insurance broker organization code? | 3 | Insurance broker name | EKIZIAN & ASSOCIATES |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 350005 |
Policy instance | 1 |
Insurance contract or identification number | 350005 | Number of Individuals Covered | 41 | Insurance policy start date | 2004-02-01 | Insurance policy end date | 2005-01-31 | Total amount of commissions paid to insurance broker | USD $9,780 | Total amount of fees paid to insurance company | USD $4,890 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $166,004 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,780 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 4890 | Additional information about fees paid to insurance broker | BONUSES, OVERRIDES, OR OTHER FEES | Insurance broker name | LISI, INC. |
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