THE UNIVERSITY OF CHICAGO has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN
Measure | Date | Value |
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2022 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2022 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-8,672,521 |
Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-8,672,521 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $9,612,686 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $8,202,347 |
Total income from all sources (including contributions) | 2022-12-31 | $153,211,976 |
Total loss/gain on sale of assets | 2022-12-31 | $0 |
Total of all expenses incurred | 2022-12-31 | $171,404,377 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $171,320,787 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $172,195,863 |
Value of total assets at end of year | 2022-12-31 | $102,221,666 |
Value of total assets at beginning of year | 2022-12-31 | $119,003,728 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $83,590 |
Total interest from all sources | 2022-12-31 | $1,249,103 |
Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
Administrative expenses professional fees incurred | 2022-12-31 | $83,590 |
Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
Value of fidelity bond cover | 2022-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
Contributions received from participants | 2022-12-31 | $47,703,181 |
Participant contributions at end of year | 2022-12-31 | $3,701,371 |
Participant contributions at beginning of year | 2022-12-31 | $1,520,447 |
Income. Received or receivable in cash from other sources (including rollovers) | 2022-12-31 | $2,523,391 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $111,873 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $90,972 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $1,810,863 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $1,752,619 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
Value of net income/loss | 2022-12-31 | $-18,192,401 |
Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $92,608,980 |
Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $110,801,381 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $49,288,365 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $58,926,940 |
Income. Interest from US Government securities | 2022-12-31 | $1,249,103 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $78,240,469 |
Asset value of US Government securities at end of year | 2022-12-31 | $49,120,057 |
Asset value of US Government securities at beginning of year | 2022-12-31 | $58,465,369 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-11,560,469 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
Contributions received in cash from employer | 2022-12-31 | $121,969,291 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $93,080,318 |
Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $7,801,823 |
Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $6,449,728 |
Did the plan have assets held for investment | 2022-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
Accountancy firm name | 2022-12-31 | MITCHELL & TITUS, LLP |
Accountancy firm EIN | 2022-12-31 | 132781641 |
2021 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2021 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $-3,064,571 |
Total unrealized appreciation/depreciation of assets | 2021-12-31 | $-3,064,571 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $8,202,347 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $6,206,067 |
Total income from all sources (including contributions) | 2021-12-31 | $167,591,408 |
Total loss/gain on sale of assets | 2021-12-31 | $0 |
Total of all expenses incurred | 2021-12-31 | $156,846,909 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $156,691,733 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $155,420,632 |
Value of total assets at end of year | 2021-12-31 | $119,003,728 |
Value of total assets at beginning of year | 2021-12-31 | $106,262,949 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $155,176 |
Total interest from all sources | 2021-12-31 | $1,103,142 |
Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
Administrative expenses professional fees incurred | 2021-12-31 | $147,191 |
Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
Value of fidelity bond cover | 2021-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
Contributions received from participants | 2021-12-31 | $43,539,202 |
Participant contributions at end of year | 2021-12-31 | $1,520,447 |
Participant contributions at beginning of year | 2021-12-31 | $947,526 |
Income. Received or receivable in cash from other sources (including rollovers) | 2021-12-31 | $1,156,458 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $90,972 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $85,905 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $1,752,619 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $582,045 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
Value of net income/loss | 2021-12-31 | $10,744,499 |
Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $110,801,381 |
Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $100,056,882 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
Investment advisory and management fees | 2021-12-31 | $7,985 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $58,926,940 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $54,114,943 |
Income. Interest from US Government securities | 2021-12-31 | $1,103,142 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $79,798,250 |
Asset value of US Government securities at end of year | 2021-12-31 | $58,465,369 |
Asset value of US Government securities at beginning of year | 2021-12-31 | $51,114,575 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $14,132,205 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
Contributions received in cash from employer | 2021-12-31 | $110,724,972 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $76,893,483 |
Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $6,449,728 |
Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $5,624,022 |
Did the plan have assets held for investment | 2021-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
Accountancy firm name | 2021-12-31 | MITCHELL & TITUS, LLP |
Accountancy firm EIN | 2021-12-31 | 132781641 |
2020 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2020 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2020-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $6,206,067 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $10,622,689 |
Total income from all sources (including contributions) | 2020-12-31 | $166,175,994 |
Total loss/gain on sale of assets | 2020-12-31 | $0 |
Total of all expenses incurred | 2020-12-31 | $146,391,841 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $146,148,996 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $151,254,914 |
Value of total assets at end of year | 2020-12-31 | $106,262,949 |
Value of total assets at beginning of year | 2020-12-31 | $90,895,418 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $242,845 |
Total interest from all sources | 2020-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $1,219,452 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $1,219,452 |
Administrative expenses professional fees incurred | 2020-12-31 | $242,019 |
Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
Value of fidelity bond cover | 2020-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
Contributions received from participants | 2020-12-31 | $40,162,091 |
Participant contributions at end of year | 2020-12-31 | $947,526 |
Participant contributions at beginning of year | 2020-12-31 | $485,855 |
Income. Received or receivable in cash from other sources (including rollovers) | 2020-12-31 | $995,824 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $85,905 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $100,308 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $582,045 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $1,034,208 |
Other income not declared elsewhere | 2020-12-31 | $1 |
Administrative expenses (other) incurred | 2020-12-31 | $826 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Value of net income/loss | 2020-12-31 | $19,784,153 |
Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $100,056,882 |
Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $80,272,729 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $54,114,943 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $46,050,264 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $0 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $7,780 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $7,780 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $81,621,381 |
Asset value of US Government securities at end of year | 2020-12-31 | $51,114,575 |
Asset value of US Government securities at beginning of year | 2020-12-31 | $44,251,211 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $5,833,355 |
Net investment gain or loss from common/collective trusts | 2020-12-31 | $7,868,272 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
Contributions received in cash from employer | 2020-12-31 | $110,096,999 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $64,527,615 |
Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $5,624,022 |
Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $9,588,481 |
Did the plan have assets held for investment | 2020-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Disclaimer |
Accountancy firm name | 2020-12-31 | MITCHELL & TITUS, LLP |
Accountancy firm EIN | 2020-12-31 | 132781641 |
2019 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2019 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $13,199,324 |
Total unrealized appreciation/depreciation of assets | 2019-12-31 | $13,199,324 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $10,622,689 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $10,711,294 |
Total income from all sources (including contributions) | 2019-12-31 | $156,425,978 |
Total loss/gain on sale of assets | 2019-12-31 | $0 |
Total of all expenses incurred | 2019-12-31 | $140,307,244 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $140,097,928 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $141,186,064 |
Value of total assets at end of year | 2019-12-31 | $90,895,418 |
Value of total assets at beginning of year | 2019-12-31 | $74,865,289 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $209,316 |
Total interest from all sources | 2019-12-31 | $1,325,020 |
Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
Administrative expenses professional fees incurred | 2019-12-31 | $207,519 |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Value of fidelity bond cover | 2019-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Contributions received from participants | 2019-12-31 | $38,242,419 |
Participant contributions at end of year | 2019-12-31 | $485,855 |
Participant contributions at beginning of year | 2019-12-31 | $877,896 |
Income. Received or receivable in cash from other sources (including rollovers) | 2019-12-31 | $389,991 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $100,308 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $98,093 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $1,034,208 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $556,398 |
Administrative expenses (other) incurred | 2019-12-31 | $1,797 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Value of net income/loss | 2019-12-31 | $16,118,734 |
Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $80,272,729 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $64,153,995 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $46,050,264 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $36,558,489 |
Income. Interest from US Government securities | 2019-12-31 | $1,324,082 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $7,780 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $24,357 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $24,357 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $938 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $74,821,933 |
Asset value of US Government securities at end of year | 2019-12-31 | $44,251,211 |
Asset value of US Government securities at beginning of year | 2019-12-31 | $37,306,454 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $715,570 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
Contributions received in cash from employer | 2019-12-31 | $102,553,654 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $65,275,995 |
Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $9,588,481 |
Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $10,154,896 |
Did the plan have assets held for investment | 2019-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
Accountancy firm name | 2019-12-31 | MITCHELL & TITUS, LLP |
Accountancy firm EIN | 2019-12-31 | 132781641 |
2018 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2018 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-732,294 |
Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-732,294 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $10,711,294 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $7,935,062 |
Total income from all sources (including contributions) | 2018-12-31 | $143,841,142 |
Total loss/gain on sale of assets | 2018-12-31 | $0 |
Total of all expenses incurred | 2018-12-31 | $134,669,265 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $134,582,446 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $145,793,000 |
Value of total assets at end of year | 2018-12-31 | $74,865,289 |
Value of total assets at beginning of year | 2018-12-31 | $62,917,180 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $86,819 |
Total interest from all sources | 2018-12-31 | $1,009,658 |
Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
Administrative expenses professional fees incurred | 2018-12-31 | $83,805 |
Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
Value of fidelity bond cover | 2018-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
Contributions received from participants | 2018-12-31 | $36,239,457 |
Participant contributions at end of year | 2018-12-31 | $877,896 |
Participant contributions at beginning of year | 2018-12-31 | $911,974 |
Income. Received or receivable in cash from other sources (including rollovers) | 2018-12-31 | $745,622 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $98,093 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $66,540 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-12-31 | $556,398 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-12-31 | $571,491 |
Administrative expenses (other) incurred | 2018-12-31 | $3,014 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
Value of net income/loss | 2018-12-31 | $9,171,877 |
Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $64,153,995 |
Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $54,982,118 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $36,558,489 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $31,059,520 |
Income. Interest from US Government securities | 2018-12-31 | $969,810 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $24,357 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $5,854 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $5,854 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $39,848 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $72,314,356 |
Asset value of US Government securities at end of year | 2018-12-31 | $37,306,454 |
Asset value of US Government securities at beginning of year | 2018-12-31 | $30,873,292 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-12-31 | $-2,229,222 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
Contributions received in cash from employer | 2018-12-31 | $108,807,921 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $62,268,090 |
Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $10,154,896 |
Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $7,363,571 |
Did the plan have assets held for investment | 2018-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Disclaimer |
Accountancy firm name | 2018-12-31 | MITCHELL & TITUS, LLP |
Accountancy firm EIN | 2018-12-31 | 132781641 |
2017 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2017 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $114,388 |
Total unrealized appreciation/depreciation of assets | 2017-12-31 | $114,388 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $7,935,062 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $5,837,105 |
Total income from all sources (including contributions) | 2017-12-31 | $143,534,325 |
Total loss/gain on sale of assets | 2017-12-31 | $0 |
Total of all expenses incurred | 2017-12-31 | $127,226,781 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $127,000,579 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $137,591,650 |
Value of total assets at end of year | 2017-12-31 | $62,917,180 |
Value of total assets at beginning of year | 2017-12-31 | $44,511,679 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $226,202 |
Total interest from all sources | 2017-12-31 | $645,976 |
Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
Administrative expenses professional fees incurred | 2017-12-31 | $224,505 |
Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
Value of fidelity bond cover | 2017-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
Contributions received from participants | 2017-12-31 | $35,401,609 |
Participant contributions at end of year | 2017-12-31 | $911,974 |
Participant contributions at beginning of year | 2017-12-31 | $1,129,675 |
Income. Received or receivable in cash from other sources (including rollovers) | 2017-12-31 | $614,672 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $66,540 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $46,668 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-12-31 | $571,491 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-12-31 | $229,544 |
Administrative expenses (other) incurred | 2017-12-31 | $1,697 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
Value of net income/loss | 2017-12-31 | $16,307,544 |
Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $54,982,118 |
Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $38,674,574 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $31,059,520 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $21,780,112 |
Income. Interest from US Government securities | 2017-12-31 | $645,931 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $5,854 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $487 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $487 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $45 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $65,413,420 |
Asset value of US Government securities at end of year | 2017-12-31 | $30,873,292 |
Asset value of US Government securities at beginning of year | 2017-12-31 | $21,554,737 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-12-31 | $5,182,311 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
Contributions received in cash from employer | 2017-12-31 | $101,575,369 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $61,587,159 |
Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $7,363,571 |
Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $5,607,561 |
Did the plan have assets held for investment | 2017-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Disclaimer |
Accountancy firm name | 2017-12-31 | WASHINGTON, PITTMAN & MCKEEVER LLC |
Accountancy firm EIN | 2017-12-31 | 364189747 |
2016 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2016 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $-157,521 |
Total unrealized appreciation/depreciation of assets | 2016-12-31 | $-157,521 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $5,837,105 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $6,391,498 |
Total income from all sources (including contributions) | 2016-12-31 | $134,226,694 |
Total loss/gain on sale of assets | 2016-12-31 | $83,319 |
Total of all expenses incurred | 2016-12-31 | $124,693,157 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $124,357,479 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $131,541,199 |
Value of total assets at end of year | 2016-12-31 | $44,511,679 |
Value of total assets at beginning of year | 2016-12-31 | $35,532,535 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $335,678 |
Total interest from all sources | 2016-12-31 | $496,168 |
Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
Administrative expenses professional fees incurred | 2016-12-31 | $335,678 |
Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
Value of fidelity bond cover | 2016-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
Contributions received from participants | 2016-12-31 | $30,503,120 |
Participant contributions at end of year | 2016-12-31 | $1,129,675 |
Participant contributions at beginning of year | 2016-12-31 | $346,844 |
Income. Received or receivable in cash from other sources (including rollovers) | 2016-12-31 | $1,502,956 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $46,668 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $40,609 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-12-31 | $229,544 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-12-31 | $299,824 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Value of net income/loss | 2016-12-31 | $9,533,537 |
Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $38,674,574 |
Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $29,141,037 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $21,780,112 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $17,411,363 |
Income. Interest from US Government securities | 2016-12-31 | $495,253 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $487 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $33 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $33 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $915 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $67,720,592 |
Asset value of US Government securities at end of year | 2016-12-31 | $21,554,737 |
Asset value of US Government securities at beginning of year | 2016-12-31 | $17,733,686 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-12-31 | $2,263,529 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
Contributions received in cash from employer | 2016-12-31 | $99,535,123 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $56,636,887 |
Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $5,607,561 |
Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $6,091,674 |
Did the plan have assets held for investment | 2016-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
Aggregate proceeds on sale of assets | 2016-12-31 | $83,319 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Disclaimer |
Accountancy firm name | 2016-12-31 | WASHINGTON, PITTMAN & MCKEEVER LLC |
Accountancy firm EIN | 2016-12-31 | 364189747 |
2015 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2015 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $-304,553 |
Total unrealized appreciation/depreciation of assets | 2015-12-31 | $-304,553 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $6,391,498 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $4,840,637 |
Total income from all sources (including contributions) | 2015-12-31 | $127,327,731 |
Total loss/gain on sale of assets | 2015-12-31 | $59,246 |
Total of all expenses incurred | 2015-12-31 | $123,931,628 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $123,508,131 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $127,036,295 |
Value of total assets at end of year | 2015-12-31 | $35,532,535 |
Value of total assets at beginning of year | 2015-12-31 | $30,585,571 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $423,497 |
Total interest from all sources | 2015-12-31 | $444,504 |
Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
Administrative expenses professional fees incurred | 2015-12-31 | $423,497 |
Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
Value of fidelity bond cover | 2015-12-31 | $5,000,000 |
If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
Contributions received from participants | 2015-12-31 | $27,286,501 |
Participant contributions at end of year | 2015-12-31 | $346,844 |
Participant contributions at beginning of year | 2015-12-31 | $347,774 |
Income. Received or receivable in cash from other sources (including rollovers) | 2015-12-31 | $823,167 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $40,609 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $35,457 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-12-31 | $299,824 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-12-31 | $100,926 |
Other income not declared elsewhere | 2015-12-31 | $92,239 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Value of net income/loss | 2015-12-31 | $3,396,103 |
Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $29,141,037 |
Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $25,744,934 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $17,411,363 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $15,365,302 |
Income. Interest from US Government securities | 2015-12-31 | $444,488 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $33 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $33 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $33 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $16 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $66,354,101 |
Asset value of US Government securities at end of year | 2015-12-31 | $17,733,686 |
Asset value of US Government securities at beginning of year | 2015-12-31 | $14,837,005 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
Contributions received in cash from employer | 2015-12-31 | $98,926,627 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $57,154,030 |
Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $6,091,674 |
Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $4,739,711 |
Did the plan have assets held for investment | 2015-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
Aggregate proceeds on sale of assets | 2015-12-31 | $59,246 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Disclaimer |
Accountancy firm name | 2015-12-31 | WASHINGTON, PITTMAN & MCKEEVER LLC |
Accountancy firm EIN | 2015-12-31 | 364189747 |
2014 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2014 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $326,750 |
Total unrealized appreciation/depreciation of assets | 2014-12-31 | $326,750 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $4,840,637 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $5,247,156 |
Total income from all sources (including contributions) | 2014-12-31 | $130,990,387 |
Total loss/gain on sale of assets | 2014-12-31 | $84,066 |
Total of all expenses incurred | 2014-12-31 | $120,259,310 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $119,813,817 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $128,609,420 |
Value of total assets at end of year | 2014-12-31 | $30,585,571 |
Value of total assets at beginning of year | 2014-12-31 | $20,261,013 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $445,493 |
Total interest from all sources | 2014-12-31 | $346,362 |
Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
Administrative expenses professional fees incurred | 2014-12-31 | $445,493 |
Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
Value of fidelity bond cover | 2014-12-31 | $5,000,000 |
If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
Contributions received from participants | 2014-12-31 | $26,490,353 |
Participant contributions at end of year | 2014-12-31 | $347,774 |
Participant contributions at beginning of year | 2014-12-31 | $367,525 |
Income. Received or receivable in cash from other sources (including rollovers) | 2014-12-31 | $1,259,300 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $35,457 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $25,556 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-12-31 | $100,926 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-12-31 | $31,641 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Value of net income/loss | 2014-12-31 | $10,731,077 |
Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $25,744,934 |
Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $15,013,857 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $15,365,302 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $10,112,697 |
Income. Interest from US Government securities | 2014-12-31 | $346,329 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $33 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $1,610 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $1,610 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $33 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $63,089,242 |
Asset value of US Government securities at end of year | 2014-12-31 | $14,837,005 |
Asset value of US Government securities at beginning of year | 2014-12-31 | $9,753,625 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-12-31 | $1,623,789 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
Contributions received in cash from employer | 2014-12-31 | $100,859,767 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $56,724,575 |
Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $4,739,711 |
Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $5,215,515 |
Did the plan have assets held for investment | 2014-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
Aggregate proceeds on sale of assets | 2014-12-31 | $84,066 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Disclaimer |
Accountancy firm name | 2014-12-31 | WASHINGTON, PITTMAN & MCKEEVER LLC |
Accountancy firm EIN | 2014-12-31 | 364189747 |
2013 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2013 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $-208,689 |
Total unrealized appreciation/depreciation of assets | 2013-12-31 | $-208,689 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $5,247,156 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $5,494,172 |
Total income from all sources (including contributions) | 2013-12-31 | $125,104,967 |
Total loss/gain on sale of assets | 2013-12-31 | $69,675 |
Total of all expenses incurred | 2013-12-31 | $109,909,255 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $109,399,205 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $124,238,272 |
Value of total assets at end of year | 2013-12-31 | $20,261,013 |
Value of total assets at beginning of year | 2013-12-31 | $5,312,317 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $510,050 |
Total interest from all sources | 2013-12-31 | $123,011 |
Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
Value of fidelity bond cover | 2013-12-31 | $5,000,000 |
If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
Contributions received from participants | 2013-12-31 | $27,894,431 |
Participant contributions at end of year | 2013-12-31 | $367,525 |
Participant contributions at beginning of year | 2013-12-31 | $311,079 |
Income. Received or receivable in cash from other sources (including rollovers) | 2013-12-31 | $706,463 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $25,556 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $87 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-12-31 | $31,641 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-12-31 | $0 |
Liabilities. Value of operating payables at end of year | 2013-12-31 | $0 |
Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $102,684 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Value of net income/loss | 2013-12-31 | $15,195,712 |
Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $15,013,857 |
Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $-181,855 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-12-31 | $10,112,697 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-12-31 | $0 |
Income. Interest from US Government securities | 2013-12-31 | $122,640 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $1,610 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $5,001,151 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $5,001,151 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $371 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $69,886,131 |
Asset value of US Government securities at end of year | 2013-12-31 | $9,753,625 |
Asset value of US Government securities at beginning of year | 2013-12-31 | $0 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-12-31 | $882,698 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
Contributions received in cash from employer | 2013-12-31 | $95,637,378 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $39,513,074 |
Contract administrator fees | 2013-12-31 | $510,050 |
Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $5,215,515 |
Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $5,391,488 |
Did the plan have assets held for investment | 2013-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
Aggregate proceeds on sale of assets | 2013-12-31 | $69,675 |
Aggregate carrying amount (costs) on sale of assets | 2013-12-31 | $0 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Disclaimer |
Accountancy firm name | 2013-12-31 | WASHINGTON, PITTMAN & MCKEEVER LLC |
Accountancy firm EIN | 2013-12-31 | 364189747 |
2012 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2012 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2012-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $102,684 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $2,004,436 |
Total income from all sources (including contributions) | 2012-12-31 | $109,328,415 |
Total loss/gain on sale of assets | 2012-12-31 | $0 |
Total of all expenses incurred | 2012-12-31 | $109,287,270 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $109,064,071 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $111,888,168 |
Value of total assets at end of year | 2012-12-31 | $5,312,317 |
Value of total assets at beginning of year | 2012-12-31 | $7,172,924 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $223,199 |
Total interest from all sources | 2012-12-31 | $383 |
Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
Value of fidelity bond cover | 2012-12-31 | $5,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
Contributions received from participants | 2012-12-31 | $27,438,806 |
Participant contributions at end of year | 2012-12-31 | $311,079 |
Participant contributions at beginning of year | 2012-12-31 | $856,201 |
Assets. Other investments not covered elsewhere at end of year | 2012-12-31 | $0 |
Assets. Other investments not covered elsewhere at beginning of year | 2012-12-31 | $2,323,058 |
Income. Received or receivable in cash from other sources (including rollovers) | 2012-12-31 | $818,684 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $87 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-12-31 | $1,996,833 |
Other income not declared elsewhere | 2012-12-31 | $-2,560,136 |
Liabilities. Value of operating payables at end of year | 2012-12-31 | $102,684 |
Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $0 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Value of net income/loss | 2012-12-31 | $41,145 |
Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $5,209,633 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $5,168,488 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
Investment advisory and management fees | 2012-12-31 | $214 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $2,323,058 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $5,001,151 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $3,993,665 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $3,993,665 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $383 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $71,204,218 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
Contributions received in cash from employer | 2012-12-31 | $83,630,678 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $37,859,853 |
Contract administrator fees | 2012-12-31 | $222,985 |
Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $0 |
Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $7,603 |
Did the plan have assets held for investment | 2012-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
Accountancy firm name | 2012-12-31 | WASHINGTON, PITTMAN & MCKEEVER LLC |
Accountancy firm EIN | 2012-12-31 | 364189747 |
2011 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2011 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2011-12-31 | $-1,167,972 |
Total unrealized appreciation/depreciation of assets | 2011-12-31 | $-1,167,972 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $2,004,436 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $6,713 |
Total income from all sources (including contributions) | 2011-12-31 | $95,510,855 |
Total loss/gain on sale of assets | 2011-12-31 | $1,140,599 |
Total of all expenses incurred | 2011-12-31 | $100,793,282 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $100,646,005 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $95,068,875 |
Value of total assets at end of year | 2011-12-31 | $7,172,924 |
Value of total assets at beginning of year | 2011-12-31 | $10,457,628 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $147,277 |
Total interest from all sources | 2011-12-31 | $469,353 |
Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
Value of fidelity bond cover | 2011-12-31 | $5,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
Contributions received from participants | 2011-12-31 | $24,715,906 |
Participant contributions at end of year | 2011-12-31 | $856,201 |
Participant contributions at beginning of year | 2011-12-31 | $721,609 |
Assets. Other investments not covered elsewhere at end of year | 2011-12-31 | $2,323,058 |
Assets. Other investments not covered elsewhere at beginning of year | 2011-12-31 | $4,482,346 |
Income. Received or receivable in cash from other sources (including rollovers) | 2011-12-31 | $1,396,360 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-12-31 | $1,996,833 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-12-31 | $0 |
Liabilities. Value of operating payables at end of year | 2011-12-31 | $7,603 |
Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $6,713 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Value of net income/loss | 2011-12-31 | $-5,282,427 |
Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $5,168,488 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $10,450,915 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
Investment advisory and management fees | 2011-12-31 | $586 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $2,323,058 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $9,734,996 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $3,993,665 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $1,023 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $1,023 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $469,353 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $64,369,120 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
Contributions received in cash from employer | 2011-12-31 | $68,956,609 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $36,276,885 |
Contract administrator fees | 2011-12-31 | $146,691 |
Assets. Corporate common stocks other than exployer securities at end of year | 2011-12-31 | $0 |
Assets. Corporate common stocks other than exployer securities at beginning of year | 2011-12-31 | $5,252,650 |
Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $7,603 |
Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $6,713 |
Did the plan have assets held for investment | 2011-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
Aggregate proceeds on sale of assets | 2011-12-31 | $5,407,278 |
Aggregate carrying amount (costs) on sale of assets | 2011-12-31 | $4,266,679 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
Accountancy firm name | 2011-12-31 | WASHINGTON, PITTMAN & MCKEEVER LLC |
Accountancy firm EIN | 2011-12-31 | 364189747 |
2010 : THE UNIVERSITY OF CHICAGO HEALTH CARE PLAN 2010 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2010-12-31 | $499,347 |
Total unrealized appreciation/depreciation of assets | 2010-12-31 | $499,347 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $4,832,877 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $4,895,072 |
Total income from all sources (including contributions) | 2010-12-31 | $93,533,359 |
Total loss/gain on sale of assets | 2010-12-31 | $195,613 |
Total of all expenses incurred | 2010-12-31 | $97,794,526 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $97,667,063 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $92,482,115 |
Value of total assets at end of year | 2010-12-31 | $10,457,628 |
Value of total assets at beginning of year | 2010-12-31 | $14,780,990 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $127,463 |
Total interest from all sources | 2010-12-31 | $356,284 |
Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
Value of fidelity bond cover | 2010-12-31 | $5,000,000 |
If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
Contributions received from participants | 2010-12-31 | $23,488,949 |
Participant contributions at end of year | 2010-12-31 | $721,609 |
Participant contributions at beginning of year | 2010-12-31 | $456,032 |
Assets. Other investments not covered elsewhere at end of year | 2010-12-31 | $4,482,346 |
Assets. Other investments not covered elsewhere at beginning of year | 2010-12-31 | $6,237,548 |
Income. Received or receivable in cash from other sources (including rollovers) | 2010-12-31 | $1,021,749 |
Liabilities. Value of operating payables at end of year | 2010-12-31 | $6,713 |
Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $404,016 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Value of net income/loss | 2010-12-31 | $-4,261,167 |
Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $5,624,751 |
Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $9,885,918 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
Investment advisory and management fees | 2010-12-31 | $427 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $9,734,996 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $14,324,888 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $1,023 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $70 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $70 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $356,284 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $60,744,694 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
Contributions received in cash from employer | 2010-12-31 | $67,971,417 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $36,922,369 |
Contract administrator fees | 2010-12-31 | $127,036 |
Assets. Corporate common stocks other than exployer securities at end of year | 2010-12-31 | $5,252,650 |
Assets. Corporate common stocks other than exployer securities at beginning of year | 2010-12-31 | $8,087,340 |
Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $4,826,164 |
Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $4,491,056 |
Did the plan have assets held for investment | 2010-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
Aggregate proceeds on sale of assets | 2010-12-31 | $195,613 |
Aggregate carrying amount (costs) on sale of assets | 2010-12-31 | $0 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
Accountancy firm name | 2010-12-31 | WASHINGTON, PITTMAN & MCKEEVER LLC |
Accountancy firm EIN | 2010-12-31 | 364189747 |
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 4 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 3587 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $12,036 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $431,196 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Amount paid for insurance broker fees | 12036 | Additional information about fees paid to insurance broker | FEES - SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5392121 |
Policy instance | 9 |
Insurance contract or identification number | 5392121 | Number of Individuals Covered | 762 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $9,874 | Total amount of fees paid to insurance company | USD $1,834 | 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 | Yes | 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 $156,569 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,874 | Amount paid for insurance broker fees | 63 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 9455 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $31,733 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Amount paid for insurance broker fees | 31733 | Additional information about fees paid to insurance broker | FEES - SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 15837 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $157,047 | Total amount of fees paid to insurance company | USD $53,132 | 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 | Yes | 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 $5,843,160 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $105,503 | Amount paid for insurance broker fees | 49802 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 589886 |
Policy instance | 3 |
Insurance contract or identification number | 589886 | Number of Individuals Covered | 829 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $198,041 | Total amount of fees paid to insurance company | USD $6,912 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,274,379 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $198,041 | Amount paid for insurance broker fees | 6912 | Additional information about fees paid to insurance broker | SPECIAL PROGRAM | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028011 |
Policy instance | 5 |
Insurance contract or identification number | 30028011 | Number of Individuals Covered | 5909 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $121,352 | 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 | Yes | 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 $121,352 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30043271 |
Policy instance | 6 |
Insurance contract or identification number | 30043271 | Number of Individuals Covered | 286 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,387 | 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 | Yes | 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 $34,626 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,387 | Insurance broker organization code? | 3 |
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MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) |
Policy contract number | G8254 |
Policy instance | 7 |
Insurance contract or identification number | G8254 | Number of Individuals Covered | 24 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,544 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $357,473 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,699 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | E00067102323 |
Policy instance | 8 |
Insurance contract or identification number | E00067102323 | Number of Individuals Covered | 1518 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 $172,444 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) |
Policy contract number | G8254 |
Policy instance | 8 |
Insurance contract or identification number | G8254 | Number of Individuals Covered | 24 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $795 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $309,900 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $795 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 8887 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $34,102 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Amount paid for insurance broker fees | 34102 | Additional information about fees paid to insurance broker | FEES - SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 15207 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $151,684 | Total amount of fees paid to insurance company | USD $52,540 | 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 | Yes | 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 $5,418,004 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $81,324 | Amount paid for insurance broker fees | 32 | Additional information about fees paid to insurance broker | NON- MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1087470 |
Policy instance | 3 |
Insurance contract or identification number | 1087470 | Number of Individuals Covered | 647 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $9,314 | Total amount of fees paid to insurance company | USD $1,453 | 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 | Yes | 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 $153,325 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,314 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1453 | Additional information about fees paid to insurance broker | BONUS |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 589886 |
Policy instance | 4 |
Insurance contract or identification number | 589886 | Number of Individuals Covered | 826 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $248,311 | Total amount of fees paid to insurance company | USD $7,008 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,011,931 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $248,311 | Amount paid for insurance broker fees | 7008 | Additional information about fees paid to insurance broker | SPECIAL PROGRAM | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 5 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 3667 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $14,072 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $407,880 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 14072 | Additional information about fees paid to insurance broker | FEES - SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028011 |
Policy instance | 6 |
Insurance contract or identification number | 30028011 | Number of Individuals Covered | 5596 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $113,952 | 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 | Yes | 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 $95,537 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE467536 |
Policy instance | 9 |
Insurance contract or identification number | AE467536 | Number of Individuals Covered | 1533 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 $173,660 | 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: 12516 ) |
Policy contract number | 30043271 |
Policy instance | 7 |
Insurance contract or identification number | 30043271 | Number of Individuals Covered | 275 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,254 | 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 | Yes | 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 $30,268 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,254 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 8467 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $27,348 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 27348 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 15042 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $113,261 | Total amount of fees paid to insurance company | USD $97,457 | 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 | Yes | 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 $5,763,356 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $86,279 | Amount paid for insurance broker fees | 31 | Additional information about fees paid to insurance broker | COMMISSIONS AND FEES | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1087470 |
Policy instance | 3 |
Insurance contract or identification number | 1087470 | Number of Individuals Covered | 591 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $8,730 | 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 | Yes | 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 $141,831 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,790 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE467536 |
Policy instance | 4 |
Insurance contract or identification number | AE467536 | Number of Individuals Covered | 1541 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $373,580 | 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: 12516 ) |
Policy contract number | 30043271 |
Policy instance | 6 |
Insurance contract or identification number | 30043271 | Number of Individuals Covered | 262 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,044 | 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 | Yes | 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 $27,129 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $817 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) |
Policy contract number | G8254 |
Policy instance | 7 |
Insurance contract or identification number | G8254 | Number of Individuals Covered | 31 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,279 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $335,444 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $862 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 8 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 3808 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $12,333 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $386,090 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 12333 | Additional information about fees paid to insurance broker | FEES- SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 589886 |
Policy instance | 9 |
Insurance contract or identification number | 589886 | Number of Individuals Covered | 759 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $217,801 | Total amount of fees paid to insurance company | USD $6,624 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,852,693 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $217,801 | Amount paid for insurance broker fees | 6624 | Additional information about fees paid to insurance broker | COMMISSIONS AND FEES | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028011 |
Policy instance | 5 |
Insurance contract or identification number | 30028011 | Number of Individuals Covered | 5412 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $54,416 | 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 | Yes | 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 $54,416 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028011 |
Policy instance | 6 |
Insurance contract or identification number | 30028011 | Number of Individuals Covered | 5288 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $77,344 | 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 | Yes | 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 $77,344 | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H72045 |
Policy instance | 5 |
Insurance contract or identification number | H72045 | Number of Individuals Covered | 4184 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $13,947 | 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 $377,714 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 13947 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H89886 P89886 |
Policy instance | 4 |
Insurance contract or identification number | H89886 P89886 | Number of Individuals Covered | 753 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $229,330 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,812,518 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $229,330 | Insurance broker organization code? | 3 |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1087470 |
Policy instance | 3 |
Insurance contract or identification number | 1087470 | Number of Individuals Covered | 585 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $17,366 | 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 | Yes | 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 $141,978 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,366 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 14930 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $96,595 | Total amount of fees paid to insurance company | USD $62,577 | 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 | Yes | 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 $5,321,240 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $96,595 | Amount paid for insurance broker fees | 62577 | Additional information about fees paid to insurance broker | NON- MONETARY CONPENSATION SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 8008 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $26,727 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 26727 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
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MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) |
Policy contract number | G8254 |
Policy instance | 8 |
Insurance contract or identification number | G8254 | Number of Individuals Covered | 30 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $2,814 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $311,005 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,026 | Insurance broker organization code? | 3 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30043271 |
Policy instance | 7 |
Insurance contract or identification number | 30043271 | Number of Individuals Covered | 261 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $996 | 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 | Yes | 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 $996 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 9753 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $20,997 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 20997 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30043271 |
Policy instance | 7 |
Insurance contract or identification number | 30043271 | Number of Individuals Covered | 248 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,103 | 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 | Yes | 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 $1,103 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028011 |
Policy instance | 6 |
Insurance contract or identification number | 30028011 | Number of Individuals Covered | 5000 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $88,586 | 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 | Yes | 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 $88,586 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H72045 |
Policy instance | 5 |
Insurance contract or identification number | H72045 | Number of Individuals Covered | 4162 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $105,607 | Total amount of fees paid to insurance company | USD $9,003 | 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 $320,427 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $105,607 | Amount paid for insurance broker fees | 9003 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H89886 P89886 |
Policy instance | 4 |
Insurance contract or identification number | H89886 P89886 | Number of Individuals Covered | 766 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $225,815 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,799,530 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $225,815 | Insurance broker organization code? | 3 |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1087470 |
Policy instance | 3 |
Insurance contract or identification number | 1087470 | Number of Individuals Covered | 555 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Yes | 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 $148,641 | 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 | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 14106 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $102,349 | Total amount of fees paid to insurance company | USD $79,382 | 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 | Yes | 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 $5,132,327 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $102,349 | Amount paid for insurance broker fees | 79382 | Additional information about fees paid to insurance broker | NON- MONETARY CONPENSATION SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30043271 |
Policy instance | 7 |
Insurance contract or identification number | 30043271 | Number of Individuals Covered | 228 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $995 | 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 | Yes | 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 $995 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOCIATES INC. |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028011 |
Policy instance | 6 |
Insurance contract or identification number | 30028011 | Number of Individuals Covered | 4737 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $80,250 | 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 | Yes | 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 $80,250 | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN, INC. |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H72045 |
Policy instance | 5 |
Insurance contract or identification number | H72045 | Number of Individuals Covered | 4315 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $99,140 | Total amount of fees paid to insurance company | USD $5,568 | 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 $21,624,318 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $99,140 | Amount paid for insurance broker fees | 5568 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF ILLINOIS INC |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H89886 P89886 |
Policy instance | 4 |
Insurance contract or identification number | H89886 P89886 | Number of Individuals Covered | 783 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $220,936 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,724,481 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $220,936 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOCIATES, INC. |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H53927 |
Policy instance | 3 |
Insurance contract or identification number | H53927 | Number of Individuals Covered | 584 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $8,827 | 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 | Yes | 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 $147,117 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,827 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOC INS SRVS INC |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 14162 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $91,845 | Total amount of fees paid to insurance company | USD $82,755 | 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 | Yes | 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 $5,021,862 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $91,845 | Amount paid for insurance broker fees | 82755 | Additional information about fees paid to insurance broker | NON- MONETARY CONPENSATION SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN INC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 9461 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $24,432 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 24432 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF ILLINOIS INC |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H72045 |
Policy instance | 6 |
Insurance contract or identification number | H72045 | Number of Individuals Covered | 3846 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $90,562 | 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 $18,779,200 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $90,562 | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN INC |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | 05034 |
Policy instance | 5 |
Insurance contract or identification number | 05034 | Number of Individuals Covered | 397 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 $5,055,739 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H89886 P89886 |
Policy instance | 4 |
Insurance contract or identification number | H89886 P89886 | Number of Individuals Covered | 877 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $254,127 | 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 $4,420,200 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $254,127 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOCIATES, INC. |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H53927 |
Policy instance | 3 |
Insurance contract or identification number | H53927 | Number of Individuals Covered | 647 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $9,888 | 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 | Yes | 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 $164,798 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,888 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOC INS SRVS INC |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 9092 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $81,156 | Total amount of fees paid to insurance company | USD $36,458 | 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 | Yes | 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 $4,436,331 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $81,156 | Amount paid for insurance broker fees | 36458 | Additional information about fees paid to insurance broker | NON- MONETARY CONPENSATION SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN INC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 009641 |
Policy instance | 1 |
Insurance contract or identification number | 009641 | Number of Individuals Covered | 8722 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $22,560 | 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 | Amount paid for insurance broker fees | 22560 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF ILLINOIS INC |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30033754 |
Policy instance | 8 |
Insurance contract or identification number | 30033754 | Number of Individuals Covered | 37 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Yes | 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 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028011 |
Policy instance | 7 |
Insurance contract or identification number | 30028011 | Number of Individuals Covered | 4235 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $65,596 | Total amount of fees paid to insurance company | USD $13 | 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 | Yes | 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 $65,596 | Amount paid for insurance broker fees | 13 | Additional information about fees paid to insurance broker | FEES PAID | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN, INC. |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30043271 |
Policy instance | 9 |
Insurance contract or identification number | 30043271 | Number of Individuals Covered | 214 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $940 | 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 | Yes | 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 $940 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOCIATES INC. |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H72045 |
Policy instance | 6 |
Insurance contract or identification number | H72045 | Number of Individuals Covered | 4024 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $162,159 | 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 $19,187,436 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $162,159 | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN INC |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30043271 |
Policy instance | 9 |
Insurance contract or identification number | 30043271 | Number of Individuals Covered | 135 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $626 | 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 | Yes | 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 $626 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOCIATES INC. |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | 05034 |
Policy instance | 5 |
Insurance contract or identification number | 05034 | Number of Individuals Covered | 439 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 $5,054,324 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H89866 P89866 |
Policy instance | 4 |
Insurance contract or identification number | H89866 P89866 | Number of Individuals Covered | 811 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $240,424 | 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 $4,069,623 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $240,424 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOC SERVICES,INC |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028011 |
Policy instance | 8 |
Insurance contract or identification number | 30028011 | Number of Individuals Covered | 3829 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $58,799 | 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 | Yes | 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 $58,799 | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN, INC. |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H53927 |
Policy instance | 3 |
Insurance contract or identification number | H53927 | Number of Individuals Covered | 600 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $10,725 | 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 | Yes | 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 $178,757 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,725 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOC INS SRVS INC |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 8965 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $86,639 | Total amount of fees paid to insurance company | USD $39,010 | 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 | Yes | 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 $4,337,645 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $86,639 | Amount paid for insurance broker fees | 39010 | Additional information about fees paid to insurance broker | NON- MONETARY CONPENSATION SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | WILLIS |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 009641 |
Policy instance | 1 |
Insurance contract or identification number | 009641 | Number of Individuals Covered | 8029 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $18,300 | 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 | Amount paid for insurance broker fees | 18300 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF ILLINOIS INC |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30033754 |
Policy instance | 7 |
Insurance contract or identification number | 30033754 | Number of Individuals Covered | 33 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Yes | 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 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028011 |
Policy instance | 8 |
Insurance contract or identification number | 30028011 | Number of Individuals Covered | 3780 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $49,161 | Total amount of fees paid to insurance company | USD $532 | 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 | Yes | 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 $49,161 | Amount paid for insurance broker fees | 532 | Additional information about fees paid to insurance broker | OUTSTANDING COMMISIONS | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN, INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 8468 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $94,437 | Total amount of fees paid to insurance company | USD $43,420 | 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 | Yes | 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 $4,347,569 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $94,437 | Amount paid for insurance broker fees | 15 | Additional information about fees paid to insurance broker | NON- MONETARY CONPENSATION | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN INC |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H53927 |
Policy instance | 3 |
Insurance contract or identification number | H53927 | Number of Individuals Covered | 630 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $10,599 | 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 | Yes | 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 $176,658 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,599 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOC INS SRVS INC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H89866 P89866 |
Policy instance | 4 |
Insurance contract or identification number | H89866 P89866 | Number of Individuals Covered | 846 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $203,866 | 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 $3,394,784 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $203,866 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOC INS SERVICES |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | 05034 |
Policy instance | 5 |
Insurance contract or identification number | 05034 | Number of Individuals Covered | 462 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 $5,403,059 | 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: 12516 ) |
Policy contract number | 30033754 |
Policy instance | 7 |
Insurance contract or identification number | 30033754 | Number of Individuals Covered | 22 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Yes | 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 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 7878 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $30,000 | 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 | Amount paid for insurance broker fees | 30000 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF ILLINOIS INC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H72045 |
Policy instance | 6 |
Insurance contract or identification number | H72045 | Number of Individuals Covered | 4045 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $92,388 | 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 $18,503,536 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $69,201 | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN INC |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H53927 |
Policy instance | 3 |
Insurance contract or identification number | H53927 | Number of Individuals Covered | 602 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $10,026 | 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 | Yes | 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 $167,104 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,026 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOC INS SRVS INC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H89866 P69866 |
Policy instance | 4 |
Insurance contract or identification number | H89866 P69866 | Number of Individuals Covered | 818 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $190,513 | 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 $3,181,196 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $190,513 | Insurance broker organization code? | 3 | Insurance broker name | GARNETT-POWERS & ASSOC INS SERVICES |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 7886 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | 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 | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 13092 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $72,709 | Total amount of fees paid to insurance company | USD $33,636 | 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 | Yes | 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 $4,366,257 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $72,709 | Amount paid for insurance broker fees | 33636 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN INC |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | 05034 |
Policy instance | 5 |
Insurance contract or identification number | 05034 | Number of Individuals Covered | 513 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 $5,939,757 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H72045 |
Policy instance | 6 |
Insurance contract or identification number | H72045 | Number of Individuals Covered | 4140 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $93,830 | 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 $18,774,001 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $93,830 | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF WISCONSIN INC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H72045 |
Policy instance | 6 |
Insurance contract or identification number | H72045 | Number of Individuals Covered | 4206 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 $18,376,058 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | 05034 |
Policy instance | 5 |
Insurance contract or identification number | 05034 | Number of Individuals Covered | 537 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 $5,985,730 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H89866 P69866 |
Policy instance | 4 |
Insurance contract or identification number | H89866 P69866 | Number of Individuals Covered | 815 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $209,775 | 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 $3,523,645 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 7624 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H53927 |
Policy instance | 3 |
Insurance contract or identification number | H53927 | Number of Individuals Covered | 380 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $10,314 | 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 | Yes | 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 $171,891 | 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 | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 12965 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $29 | 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 | Yes | 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 $4,101,258 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | 05034 |
Policy instance | 5 |
Insurance contract or identification number | 05034 | Number of Individuals Covered | 558 | 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 | 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 $4,773,236 | 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 | 0102797 |
Policy instance | 2 |
Insurance contract or identification number | 0102797 | Number of Individuals Covered | 16720 | 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 $19 | 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 | Yes | 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 $3,880,532 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H53927 |
Policy instance | 3 |
Insurance contract or identification number | H53927 | Number of Individuals Covered | 385 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $9,658 | 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 | Yes | 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 $160,966 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 992715 |
Policy instance | 1 |
Insurance contract or identification number | 992715 | Number of Individuals Covered | 4213 | 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 | 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 $16,271,732 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H89866 P69866 |
Policy instance | 4 |
Insurance contract or identification number | H89866 P69866 | Number of Individuals Covered | 750 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $179,281 | 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 $2,986,854 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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