FOREST CITY ENTERPRISES, INC. has sponsored the creation of one or more 401k plans.
Additional information about FOREST CITY ENTERPRISES, INC.
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
Policy contract number | 95740-1-3 |
Policy instance | 1 |
Insurance contract or identification number | 95740-1-3 | Number of Individuals Covered | 172 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,173,690 | 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 | 3335226 |
Policy instance | 12 |
Insurance contract or identification number | 3335226 | Number of Individuals Covered | 1831 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $82,746 | Welfare Benefit Premiums Paid to Carrier | USD $827,288 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $82,746 | Insurance broker organization code? | 3 | Insurance broker name | ADVANTAGE CONSULTANTS AGENCY, INC. |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 103291-000 |
Policy instance | 3 |
Insurance contract or identification number | 103291-000 | Number of Individuals Covered | 125 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $621,034 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 21011-0000 |
Policy instance | 2 |
Insurance contract or identification number | 21011-0000 | Number of Individuals Covered | 82 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $599,407 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AIG (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 0009115281 |
Policy instance | 4 |
Insurance contract or identification number | GTP 0009115281 | Number of Individuals Covered | 2781 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $14,119 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CAREMARK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | FCERX |
Policy instance | 5 |
Insurance contract or identification number | FCERX | Number of Individuals Covered | 1411 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $2,699,254 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
Policy contract number | 843604 |
Policy instance | 6 |
Insurance contract or identification number | 843604 | Number of Individuals Covered | 650 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $29,165 | Total amount of fees paid to insurance company | USD $40 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Welfare Benefit Premiums Paid to Carrier | USD $900,793 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,165 | Amount paid for insurance broker fees | 40 | Insurance broker organization code? | 3 | Insurance broker name | ADVANTAGE CONSULTANTS AGENCY |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 7 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1548 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $975,329 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 8 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 2248 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $15,873 | Total amount of fees paid to insurance company | USD $15,886 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $800,453 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,873 | Amount paid for insurance broker fees | 15886 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE, INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 9 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 925 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $8,981 | Total amount of fees paid to insurance company | USD $6,028 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $300,626 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,981 | Amount paid for insurance broker fees | 6028 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE, INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 10 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 50 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Other welfare benefits provided | P/T AD&D | Welfare Benefit Premiums Paid to Carrier | USD $24 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 12221977 0001 |
Policy instance | 11 |
Insurance contract or identification number | 12221977 0001 | Number of Individuals Covered | 1383 | 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 $225,350 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 21011-0000 |
Policy instance | 2 |
Insurance contract or identification number | 21011-0000 | Number of Individuals Covered | 45 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $703,174 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL16669 |
Policy instance | 13 |
Insurance contract or identification number | HCL16669 | Number of Individuals Covered | 895 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Welfare Benefit Premiums Paid to Carrier | USD $608,018 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 103291-000 |
Policy instance | 3 |
Insurance contract or identification number | 103291-000 | Number of Individuals Covered | 56 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $664,386 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON BEHAVIORAL SERVICES, LLC (National Association of Insurance Commissioners NAIC id number: 62221 ) |
Policy contract number | 845316-06418 |
Policy instance | 4 |
Insurance contract or identification number | 845316-06418 | Number of Individuals Covered | 2906 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $50,286 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
Policy contract number | 95740-1-3 |
Policy instance | 1 |
Insurance contract or identification number | 95740-1-3 | Number of Individuals Covered | 168 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,171,742 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAREMARK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | FCERX |
Policy instance | 6 |
Insurance contract or identification number | FCERX | Number of Individuals Covered | 1539 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $3,298,470 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
Policy contract number | 843604 |
Policy instance | 7 |
Insurance contract or identification number | 843604 | Number of Individuals Covered | 640 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $30,037 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Welfare Benefit Premiums Paid to Carrier | USD $804,517 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,037 | Insurance broker organization code? | 3 | Insurance broker name | ADVANTAGE CONSULTANTS AGENCY |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 8 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1573 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $965,532 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 9 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 951 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $9,009 | Total amount of fees paid to insurance company | USD $5,798 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $307,471 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,009 | Amount paid for insurance broker fees | 5798 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE, INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 11 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 55 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Other welfare benefits provided | P/T AD&D | Welfare Benefit Premiums Paid to Carrier | USD $26 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 12221977 0001 |
Policy instance | 12 |
Insurance contract or identification number | 12221977 0001 | Number of Individuals Covered | 1388 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $212,369 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 10 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 2321 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $15,377 | Total amount of fees paid to insurance company | USD $14,433 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $768,936 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,377 | Amount paid for insurance broker fees | 14433 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE, INC. |
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AIG (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 0009115281 |
Policy instance | 5 |
Insurance contract or identification number | GTP 0009115281 | Number of Individuals Covered | 2906 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $14,119 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL16669 |
Policy instance | 13 |
Insurance contract or identification number | HCL16669 | Number of Individuals Covered | 923 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Welfare Benefit Premiums Paid to Carrier | USD $614,531 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 12221977 0001 |
Policy instance | 12 |
Insurance contract or identification number | 12221977 0001 | Number of Individuals Covered | 1362 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $194,654 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
Policy contract number | 95740-1-3 |
Policy instance | 1 |
Insurance contract or identification number | 95740-1-3 | Number of Individuals Covered | 158 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,113,986 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 21011-0000 |
Policy instance | 2 |
Insurance contract or identification number | 21011-0000 | Number of Individuals Covered | 51 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $631,357 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON BEHAVIORAL SERVICES, LLC (National Association of Insurance Commissioners NAIC id number: 62221 ) |
Policy contract number | 845316-06418 |
Policy instance | 4 |
Insurance contract or identification number | 845316-06418 | Number of Individuals Covered | 2985 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $40,106 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 103291-000 |
Policy instance | 3 |
Insurance contract or identification number | 103291-000 | Number of Individuals Covered | 60 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $614,166 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AIG (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 0009115281 |
Policy instance | 5 |
Insurance contract or identification number | GTP 0009115281 | Number of Individuals Covered | 2922 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $4,707 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAREMARK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | FCERX |
Policy instance | 6 |
Insurance contract or identification number | FCERX | Number of Individuals Covered | 1529 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $2,905,883 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 8 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1639 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $957,323 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 9 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1084 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $9,110 | Total amount of fees paid to insurance company | USD $3,793 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $311,170 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,110 | Amount paid for insurance broker fees | 3793 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE, INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 10 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 2228 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $15,291 | Total amount of fees paid to insurance company | USD $9,171 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $768,916 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,291 | Amount paid for insurance broker fees | 9171 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE, INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 11 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 56 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Other welfare benefits provided | P/T AD&D | Welfare Benefit Premiums Paid to Carrier | USD $26 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
Policy contract number | 843604 |
Policy instance | 7 |
Insurance contract or identification number | 843604 | Number of Individuals Covered | 614 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $28,234 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Were dividends or retroactive rate refunds paid as a credit? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $776,089 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,234 | Insurance broker organization code? | 3 | Insurance broker name | ADVANTAGE CONSULTANTS AGENCY |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 11 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 61 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of fees paid to insurance company | USD $22 | Other welfare benefits provided | P/T AD&D | Welfare Benefit Premiums Paid to Carrier | USD $29 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 22 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE, INC. |
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HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
Policy contract number | 95740-1-3 |
Policy instance | 1 |
Insurance contract or identification number | 95740-1-3 | Number of Individuals Covered | 155 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,176,381 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 21011-0000 |
Policy instance | 2 |
Insurance contract or identification number | 21011-0000 | Number of Individuals Covered | 54 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $592,739 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HORIZON BEHAVIORAL SERVICES, LLC (National Association of Insurance Commissioners NAIC id number: 62221 ) |
Policy contract number | 845316-06418 |
Policy instance | 4 |
Insurance contract or identification number | 845316-06418 | Number of Individuals Covered | 2714 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $30,005 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 103291-000 |
Policy instance | 3 |
Insurance contract or identification number | 103291-000 | Number of Individuals Covered | 66 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $602,208 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AIG (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 0009115281 |
Policy instance | 5 |
Insurance contract or identification number | GTP 0009115281 | Number of Individuals Covered | 2960 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $7,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CAREMARK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | FCERX |
Policy instance | 6 |
Insurance contract or identification number | FCERX | Number of Individuals Covered | 1368 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,808,655 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
Policy contract number | 843604 |
Policy instance | 7 |
Insurance contract or identification number | 843604 | Number of Individuals Covered | 850 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $32,844 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Were dividends or retroactive rate refunds paid as a credit? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,111,597 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,844 | Insurance broker organization code? | 3 | Insurance broker name | ADVANTAGE CONSULTANTS AGENCY |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 8 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1675 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $967,556 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL16669 |
Policy instance | 14 |
Insurance contract or identification number | HCL16669 | Number of Individuals Covered | 542 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Welfare Benefit Premiums Paid to Carrier | USD $542,508 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 12221977 0002 |
Policy instance | 13 |
Insurance contract or identification number | 12221977 0002 | Number of Individuals Covered | 22 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,788 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 12221977 0001 |
Policy instance | 12 |
Insurance contract or identification number | 12221977 0001 | Number of Individuals Covered | 1110 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $159,753 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 10 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 2145 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $14,953 | Total amount of fees paid to insurance company | USD $6,507 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $652,654 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,953 | Amount paid for insurance broker fees | 6507 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE, INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 9 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1098 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $8,897 | Total amount of fees paid to insurance company | USD $3,034 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $291,557 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,897 | Amount paid for insurance broker fees | 3034 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE, INC. |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 21011-0000 |
Policy instance | 2 |
Insurance contract or identification number | 21011-0000 | Number of Individuals Covered | 53 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $539,458 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 103291-000 |
Policy instance | 3 |
Insurance contract or identification number | 103291-000 | Number of Individuals Covered | 63 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $555,951 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 12221977 |
Policy instance | 4 |
Insurance contract or identification number | 12221977 | Number of Individuals Covered | 1302 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $155,336 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON BEHAVIORAL SERVICES, LLC (National Association of Insurance Commissioners NAIC id number: 62221 ) |
Policy contract number | 06418 |
Policy instance | 5 |
Insurance contract or identification number | 06418 | Number of Individuals Covered | 2361 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $42,879 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AIG (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 0009115281 |
Policy instance | 6 |
Insurance contract or identification number | GTP 0009115281 | Number of Individuals Covered | 3019 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $7,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAREMARK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | FCERX |
Policy instance | 7 |
Insurance contract or identification number | FCERX | Number of Individuals Covered | 1383 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,743,932 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
Policy contract number | NJ54 |
Policy instance | 8 |
Insurance contract or identification number | NJ54 | Number of Individuals Covered | 550 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $12,272 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 10 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1636 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $940,089 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 11 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1116 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $9,804 | Total amount of fees paid to insurance company | USD $3,096 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $364,178 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 12 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 2145 | 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 $5,143 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $612,783 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 13 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 76 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of fees paid to insurance company | USD $16 | Other welfare benefits provided | P/T AD&D | Welfare Benefit Premiums Paid to Carrier | USD $34 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
Policy contract number | 95740-1-3 |
Policy instance | 1 |
Insurance contract or identification number | 95740-1-3 | Number of Individuals Covered | 165 | Insurance policy start date | 2011-01-31 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,195,979 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
Policy contract number | 843604 |
Policy instance | 9 |
Insurance contract or identification number | 843604 | Number of Individuals Covered | 874 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $35,971 | Total amount of fees paid to insurance company | USD $55,247 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Welfare Benefit Premiums Paid to Carrier | USD $1,042,836 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL16669 |
Policy instance | 14 |
Insurance contract or identification number | HCL16669 | Number of Individuals Covered | 542 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Welfare Benefit Premiums Paid to Carrier | USD $430,939 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 13 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1100 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $14,810 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $534,322 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 067097 |
Policy instance | 5 |
Insurance contract or identification number | 067097 | Number of Individuals Covered | 47 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $571,443 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAREMARK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | FCERX |
Policy instance | 9 |
Insurance contract or identification number | FCERX | Number of Individuals Covered | 1360 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,654,004 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 103291-000 |
Policy instance | 4 |
Insurance contract or identification number | 103291-000 | Number of Individuals Covered | 71 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $333,279 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 21011-0000 |
Policy instance | 3 |
Insurance contract or identification number | 21011-0000 | Number of Individuals Covered | 52 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $279,624 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
Policy contract number | 95740-1-3 |
Policy instance | 2 |
Insurance contract or identification number | 95740-1-3 | Number of Individuals Covered | 164 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,674,610 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | 00302157 |
Policy instance | 1 |
Insurance contract or identification number | 00302157 | Number of Individuals Covered | 35 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $308,572 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 12221977 |
Policy instance | 6 |
Insurance contract or identification number | 12221977 | Number of Individuals Covered | 1086 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $150,397 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON BEHAVIORAL SERVICES, LLC (National Association of Insurance Commissioners NAIC id number: 62221 ) |
Policy contract number | 06418 |
Policy instance | 7 |
Insurance contract or identification number | 06418 | Number of Individuals Covered | 2342 | Insurance policy start date | 2009-09-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $47,433 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AIG (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 0009115281 |
Policy instance | 8 |
Insurance contract or identification number | GTP 0009115281 | Number of Individuals Covered | 2054 | Insurance policy start date | 2009-11-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $15,166 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
Policy contract number | 843604 |
Policy instance | 11 |
Insurance contract or identification number | 843604 | Number of Individuals Covered | 904 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $17,692 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Welfare Benefit Premiums Paid to Carrier | USD $580,326 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 12 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1661 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,343,276 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL16669 |
Policy instance | 16 |
Insurance contract or identification number | HCL16669 | Number of Individuals Covered | 438 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Welfare Benefit Premiums Paid to Carrier | USD $323,265 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 15 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 70 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | P/T AD&D | Welfare Benefit Premiums Paid to Carrier | USD $26 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 94958 |
Policy instance | 14 |
Insurance contract or identification number | 94958 | Number of Individuals Covered | 1485 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $12,500 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $802,341 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
Policy contract number | NJ54 |
Policy instance | 10 |
Insurance contract or identification number | NJ54 | Number of Individuals Covered | 442 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $10,934 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ADMINISTRATION CONTRACT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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