GEORGES ENTERPRISES, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GEORGES ENTERPRISES, LLC MEDICAL PLAN
Measure | Date | Value |
---|
2017: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-02-01 | 571 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 0 |
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 | 0 |
2016: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-02-01 | 603 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 549 |
Number of retired or separated participants receiving benefits | 2016-02-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2016-02-01 | 0 |
Total of all active and inactive participants | 2016-02-01 | 550 |
2015: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-02-01 | 642 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 601 |
Number of retired or separated participants receiving benefits | 2015-02-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2015-02-01 | 8 |
Total of all active and inactive participants | 2015-02-01 | 610 |
2014: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-02-01 | 615 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 628 |
Number of retired or separated participants receiving benefits | 2014-02-01 | 4 |
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 | 632 |
2013: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-02-01 | 261 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 271 |
Number of retired or separated participants receiving benefits | 2013-02-01 | 2 |
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 | 273 |
2012: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-02-01 | 249 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 259 |
Number of retired or separated participants receiving benefits | 2012-02-01 | 2 |
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 | 261 |
2011: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-02-01 | 289 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 248 |
Number of retired or separated participants receiving benefits | 2011-02-01 | 1 |
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 | 249 |
2017: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2017 form 5500 responses |
---|
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 | Yes |
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: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2016 form 5500 responses |
---|
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: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2015 form 5500 responses |
---|
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: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2014 form 5500 responses |
---|
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: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2013 form 5500 responses |
---|
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: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2012 form 5500 responses |
---|
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: GEORGES ENTERPRISES, LLC MEDICAL PLAN 2011 form 5500 responses |
---|
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 |
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
Policy contract number | 78A77ERC |
Policy instance | 1 |
Insurance contract or identification number | 78A77ERC | Number of Individuals Covered | 798 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $24,734 | 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 | 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 $451,436 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,734 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFITS CORPORATION |
|
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 ) |
Policy contract number | 170-0028 |
Policy instance | 1 |
Insurance contract or identification number | 170-0028 | Number of Individuals Covered | 602 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $31,221 | 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 | 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 $520,353 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,221 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFITS CORPORATION |
|
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
Policy contract number | 78A77ERC |
Policy instance | 2 |
Insurance contract or identification number | 78A77ERC | Number of Individuals Covered | 989 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $74,368 | Total amount of fees paid to insurance company | USD $7,032 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $74,368 | Amount paid for insurance broker fees | 7032 | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFITS CORPORATION |
|
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
Policy contract number | 657130 |
Policy instance | 1 |
Insurance contract or identification number | 657130 | Number of Individuals Covered | 627 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $79,086 | 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 | 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 $494,289 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $79,086 | Insurance broker organization code? | 3 | Insurance broker name | CANYON RE, LLC |
|
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
Policy contract number | 000000000000000 |
Policy instance | 6 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 273 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $27,795 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $299,103 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,250 | Insurance broker organization code? | 3 | Insurance broker name | GILSBAR, LLC |
|
HEALTH ONE ALLIANCE (National Association of Insurance Commissioners NAIC id number: 11256 ) |
Policy contract number | 000000000000000 |
Policy instance | 5 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 273 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | 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 | 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 $1,440 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MEDCOM CARE MANAGEMENT, INC. (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 000000000000000 |
Policy instance | 3 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 273 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | UTILIZATION REVIEW, DISEASE MANAGEMENT | 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 $20,615 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRIVATE HEALTHCARE SYSTEMS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 000000000000000 |
Policy instance | 4 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 273 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | 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 | 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 $2,364 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 000000000000000 |
Policy instance | 2 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 273 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $-89 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $-650 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $-41 | Insurance broker organization code? | 5 | Insurance broker name | EMPLOYEE BENEFITS CORPORATION |
|
GILSBAR 360 ALLIANCE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 0000000000 |
Policy instance | 1 |
Insurance contract or identification number | 0000000000 | Number of Individuals Covered | 273 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | 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 | 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 $12,351 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 000000000000000 |
Policy instance | 2 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 234 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $48,261 | Total amount of fees paid to insurance company | USD $156,214 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $354,150 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,112 | Amount paid for insurance broker fees | 111262 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES ONLY CONTRACT | Insurance broker organization code? | 5 | Insurance broker name | EMPLOYEE BENEFITS CORPORATION |
|
MEDCOM CARE MANAGEMENT, INC. (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 000000000000000 |
Policy instance | 3 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 234 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | UTILIZATION REVIEW, DISEASE MANAGEMENT | 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 $18,469 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRIVATE HEALTHCARE SYSTEMS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 000000000000000 |
Policy instance | 4 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 234 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | 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 | 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 $3,329 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH ONE ALLIANCE (National Association of Insurance Commissioners NAIC id number: 11256 ) |
Policy contract number | 000000000000000 |
Policy instance | 5 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 234 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | 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 | 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 $240 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GILSBAR 360 ALLIANCE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 0000000000 |
Policy instance | 1 |
Insurance contract or identification number | 0000000000 | Number of Individuals Covered | 234 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | 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 | 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 $11,700 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GILSBAR 360 ALLIANCE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 0000000000 |
Policy instance | 1 |
Insurance contract or identification number | 0000000000 | Number of Individuals Covered | 249 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | 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 | 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 $12,625 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 000000000000000 |
Policy instance | 2 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 249 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $44,608 | Total amount of fees paid to insurance company | USD $148,415 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $327,266 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MEDCOM CARE MANAGEMENT, INC. (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 000000000000000 |
Policy instance | 3 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 249 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | UTILIZATION REVIEW, DISEASE MANAGEMENT | 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 $17,210 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRIVATE HEALTHCARE SYSTEMS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 000000000000000 |
Policy instance | 4 |
Insurance contract or identification number | 000000000000000 | Number of Individuals Covered | 249 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | 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 | 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 $1,872 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|