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THE BRETHREN CARE INC PREMIUM ONLY PLAN 401k Plan overview

Plan NameTHE BRETHREN CARE INC PREMIUM ONLY PLAN
Plan identification number 502

THE BRETHREN CARE INC PREMIUM ONLY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Supplemental unemployment
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

BRETHREN CARE INC has sponsored the creation of one or more 401k plans.

Company Name:BRETHREN CARE INC
Employer identification number (EIN):341095056
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about BRETHREN CARE INC

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1970-12-17
Company Identification Number: 404973
Legal Registered Office Address: 3800 EMBASSY PARKWAY
SUITE 300
AKRON
United States of America (USA)
44333

More information about BRETHREN CARE INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE BRETHREN CARE INC PREMIUM ONLY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022016-05-01ANNA SMITH
5022015-05-01ANNA SMITH
5022014-05-01ANNA SMITH
5022013-05-01ANNA SMITH
5022012-05-01ANNA SMITH
5022011-05-01ANNA SMITH
5022009-05-01ANNA SMITH
5022008-05-01ANNA SMITH
5022007-05-01ANNA SMITH
5022006-05-01ANNA SMITH
5022005-05-01ANNA SMITH
5022004-05-01ANNA SMITH

Plan Statistics for THE BRETHREN CARE INC PREMIUM ONLY PLAN

401k plan membership statisitcs for THE BRETHREN CARE INC PREMIUM ONLY PLAN

Measure Date Value
2016: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01146
Total number of active participants reported on line 7a of the Form 55002016-05-01161
Number of retired or separated participants receiving benefits2016-05-012
Total of all active and inactive participants2016-05-01163
Total participants2016-05-01163
2015: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01322
Total number of active participants reported on line 7a of the Form 55002015-05-01143
Number of retired or separated participants receiving benefits2015-05-013
Total of all active and inactive participants2015-05-01146
Total participants2015-05-01146
2014: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-01297
Total number of active participants reported on line 7a of the Form 55002014-05-01321
Number of retired or separated participants receiving benefits2014-05-011
Total of all active and inactive participants2014-05-01322
Total participants2014-05-01322
2013: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01290
Total number of active participants reported on line 7a of the Form 55002013-05-01297
Total of all active and inactive participants2013-05-01297
Total participants2013-05-01297
2012: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01179
Total number of active participants reported on line 7a of the Form 55002012-05-01290
Total of all active and inactive participants2012-05-01290
Total participants2012-05-01290
2011: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01163
Total number of active participants reported on line 7a of the Form 55002011-05-01179
Total of all active and inactive participants2011-05-01179
Total participants2011-05-01179
2009: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01150
Total number of active participants reported on line 7a of the Form 55002009-05-01156
Total of all active and inactive participants2009-05-01156
Total participants2009-05-01156
2008: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2008 401k membership
Total participants, beginning-of-year2008-05-01136
Total number of active participants reported on line 7a of the Form 55002008-05-01150
Total of all active and inactive participants2008-05-01150
Total participants2008-05-01150
2007: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2007 401k membership
Total participants, beginning-of-year2007-05-01135
Total number of active participants reported on line 7a of the Form 55002007-05-01136
Total of all active and inactive participants2007-05-01136
Total participants2007-05-01136
2006: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2006 401k membership
Total participants, beginning-of-year2006-05-01143
Total number of active participants reported on line 7a of the Form 55002006-05-01135
Total of all active and inactive participants2006-05-01135
Total participants2006-05-01135
2005: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2005 401k membership
Total participants, beginning-of-year2005-05-01124
Total number of active participants reported on line 7a of the Form 55002005-05-01143
Total of all active and inactive participants2005-05-01143
Total participants2005-05-01143
2004: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2004 401k membership
Total participants, beginning-of-year2004-05-01124
Total number of active participants reported on line 7a of the Form 55002004-05-01124
Total of all active and inactive participants2004-05-01124
Total participants2004-05-01124

Form 5500 Responses for THE BRETHREN CARE INC PREMIUM ONLY PLAN

2016: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes
2009: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Submission has been amendedNo
2009-05-01This submission is the final filingNo
2009-05-01This return/report is a short plan year return/report (less than 12 months)No
2009-05-01Plan is a collectively bargained planNo
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan benefit arrangement – InsuranceYes
2008: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2008 form 5500 responses
2008-05-01Type of plan entitySingle employer plan
2008-05-01Submission has been amendedNo
2008-05-01This submission is the final filingNo
2008-05-01This return/report is a short plan year return/report (less than 12 months)No
2008-05-01Plan is a collectively bargained planNo
2008-05-01Plan funding arrangement – InsuranceYes
2008-05-01Plan benefit arrangement – InsuranceYes
2007: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2007 form 5500 responses
2007-05-01Type of plan entitySingle employer plan
2007-05-01Submission has been amendedNo
2007-05-01This submission is the final filingNo
2007-05-01This return/report is a short plan year return/report (less than 12 months)No
2007-05-01Plan is a collectively bargained planNo
2007-05-01Plan funding arrangement – InsuranceYes
2007-05-01Plan benefit arrangement – InsuranceYes
2006: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2006 form 5500 responses
2006-05-01Type of plan entitySingle employer plan
2006-05-01Submission has been amendedNo
2006-05-01This submission is the final filingNo
2006-05-01This return/report is a short plan year return/report (less than 12 months)No
2006-05-01Plan is a collectively bargained planNo
2006-05-01Plan funding arrangement – InsuranceYes
2006-05-01Plan benefit arrangement – InsuranceYes
2005: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2005 form 5500 responses
2005-05-01Type of plan entitySingle employer plan
2005-05-01Submission has been amendedNo
2005-05-01This submission is the final filingNo
2005-05-01This return/report is a short plan year return/report (less than 12 months)No
2005-05-01Plan is a collectively bargained planNo
2005-05-01Plan funding arrangement – InsuranceYes
2005-05-01Plan benefit arrangement – InsuranceYes
2004: THE BRETHREN CARE INC PREMIUM ONLY PLAN 2004 form 5500 responses
2004-05-01Type of plan entitySingle employer plan
2004-05-01Submission has been amendedNo
2004-05-01This submission is the final filingNo
2004-05-01This return/report is a short plan year return/report (less than 12 months)No
2004-05-01Plan is a collectively bargained planNo
2004-05-01Plan funding arrangement – InsuranceYes
2004-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberKG321
Policy instance 3
Insurance contract or identification numberKG321
Number of Individuals Covered52
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $3,396
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1
Insurance broker organization code?3
Insurance broker nameMICHAEL W BERUBE
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 4
Insurance contract or identification number00395741
Number of Individuals Covered146
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $7,865
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $114,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,865
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameADRIENNE E VAUGHAN
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7154222
Policy instance 2
Insurance contract or identification numberE7154222
Number of Individuals Covered6
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $260
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $206
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFITS SERVICES INC
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number0039978-01
Policy instance 1
Insurance contract or identification number0039978-01
Number of Individuals Covered117
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $29,608
Total amount of fees paid to insurance companyUSD $43
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,608
Amount paid for insurance broker fees43
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameGIBSON MYERS AND ASSOCIATES, INC.
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number0039978-01
Policy instance 4
Insurance contract or identification number0039978-01
Number of Individuals Covered120
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $31,296
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,296
Insurance broker organization code?3
Insurance broker nameGIBSON MYERS AND ASSOCIATES, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 1
Insurance contract or identification number00395741
Number of Individuals Covered143
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $8,253
Total amount of fees paid to insurance companyUSD $3,192
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $118,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,253
Amount paid for insurance broker fees3192
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameADRIENNE E VAUGHAN
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberKG321
Policy instance 2
Insurance contract or identification numberKG321
Number of Individuals Covered59
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $2,809
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5
Insurance broker organization code?3
Insurance broker nameJENNIFER M CAMPANA
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7154222
Policy instance 3
Insurance contract or identification numberE7154222
Number of Individuals Covered7
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $362
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $267
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFITS SERVICES INC
SUMMACARE (National Association of Insurance Commissioners NAIC id number: 95202 )
Policy contract numberG05955
Policy instance 2
Insurance contract or identification numberG05955
Number of Individuals Covered128
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $31,540
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,261,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,540
Insurance broker organization code?3
Insurance broker nameASSOCIATED UNDERWRITERS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 3
Insurance contract or identification number00395741
Number of Individuals Covered150
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $8,627
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $134,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $142
Insurance broker organization code?3
Insurance broker nameEDWARD D SOMMER
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7154222
Policy instance 1
Insurance contract or identification numberE7154222
Number of Individuals Covered8
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $396
Total amount of fees paid to insurance companyUSD $21
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $291
Amount paid for insurance broker fees18
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFITS SERVICES INC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7154222
Policy instance 3
Insurance contract or identification numberE7154222
Number of Individuals Covered10
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $439
Total amount of fees paid to insurance companyUSD $33
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $305
Amount paid for insurance broker fees25
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameCENTRAL OHIO GROUP INSURANCE AGENCY
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number846679
Policy instance 2
Insurance contract or identification number846679
Number of Individuals Covered290
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $51,189
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,534,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,189
Insurance broker organization code?3
Insurance broker nameGIBSON-MYERS & ASSOC INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 1
Insurance contract or identification number00395741
Number of Individuals Covered164
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $13,645
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $201,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,241
Insurance broker organization code?3
Insurance broker nameADRIENNE E VAUGHAN
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 1
Insurance contract or identification number00395741
Number of Individuals Covered179
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $12,188
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $178,400
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
Policy instance 2
Number of Individuals Covered125
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $49,737
Total amount of fees paid to insurance companyUSD $19
Health Insurance Welfare BenefitYes
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
Policy instance 2
Number of Individuals Covered119
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $41,349
Total amount of fees paid to insurance companyUSD $27,933
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 1
Insurance contract or identification number00395741
Number of Individuals Covered163
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $14,388
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $202,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 1
Insurance contract or identification number00395741
Number of Individuals Covered150
Insurance policy start date2008-07-01
Insurance policy end date2009-06-30
Total amount of commissions paid to insurance brokerUSD $11,956
Total amount of fees paid to insurance companyUSD $7,823
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $157,503
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 numberHCL16455
Policy instance 2
Insurance contract or identification numberHCL16455
Number of Individuals Covered95
Insurance policy start date2008-05-01
Insurance policy end date2009-04-30
Total amount of commissions paid to insurance brokerUSD $26,454
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,397
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 1
Insurance contract or identification number00395741
Number of Individuals Covered136
Insurance policy start date2007-07-01
Insurance policy end date2008-06-30
Total amount of commissions paid to insurance brokerUSD $13,039
Total amount of fees paid to insurance companyUSD $7,603
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $147,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 1
Insurance contract or identification number00395741
Number of Individuals Covered135
Insurance policy start date2006-07-01
Insurance policy end date2007-06-30
Total amount of commissions paid to insurance brokerUSD $10,881
Total amount of fees paid to insurance companyUSD $7,597
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $143,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 1
Insurance contract or identification number00395741
Number of Individuals Covered143
Insurance policy start date2005-07-01
Insurance policy end date2006-06-30
Total amount of commissions paid to insurance brokerUSD $9,548
Total amount of fees paid to insurance companyUSD $5,637
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $116,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00395741
Policy instance 1
Insurance contract or identification number00395741
Number of Individuals Covered124
Insurance policy start date2004-07-01
Insurance policy end date2005-06-30
Total amount of commissions paid to insurance brokerUSD $6,136
Total amount of fees paid to insurance companyUSD $2,828
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $85,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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