SIEMER MILLING COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SIEMER MILLING COMPANY HEALTH CARE PLAN
Measure | Date | Value |
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2022: SIEMER MILLING COMPANY HEALTH CARE PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-05-01 | 155 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-05-01 | 151 |
Number of retired or separated participants receiving benefits | 2022-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-05-01 | 0 |
Total of all active and inactive participants | 2022-05-01 | 151 |
2021: SIEMER MILLING COMPANY HEALTH CARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-05-01 | 151 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 151 |
Total of all active and inactive participants | 2021-05-01 | 151 |
Total participants | 2021-05-01 | 151 |
2020: SIEMER MILLING COMPANY HEALTH CARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-05-01 | 152 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 151 |
Total of all active and inactive participants | 2020-05-01 | 151 |
Total participants | 2020-05-01 | 151 |
2019: SIEMER MILLING COMPANY HEALTH CARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-05-01 | 159 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 152 |
Total of all active and inactive participants | 2019-05-01 | 152 |
Total participants | 2019-05-01 | 152 |
2018: SIEMER MILLING COMPANY HEALTH CARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-05-01 | 153 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 159 |
Total of all active and inactive participants | 2018-05-01 | 159 |
Total participants | 2018-05-01 | 159 |
2017: SIEMER MILLING COMPANY HEALTH CARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-05-01 | 147 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 153 |
Total of all active and inactive participants | 2017-05-01 | 153 |
Total participants | 2017-05-01 | 153 |
2016: SIEMER MILLING COMPANY HEALTH CARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-05-01 | 142 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 147 |
Total of all active and inactive participants | 2016-05-01 | 147 |
Total participants | 2016-05-01 | 147 |
2015: SIEMER MILLING COMPANY HEALTH CARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-05-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 142 |
Total of all active and inactive participants | 2015-05-01 | 142 |
Total participants | 2015-05-01 | 142 |
2014: SIEMER MILLING COMPANY HEALTH CARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-05-01 | 105 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 123 |
Total of all active and inactive participants | 2014-05-01 | 123 |
Total participants | 2014-05-01 | 123 |
2013: SIEMER MILLING COMPANY HEALTH CARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-05-01 | 111 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 105 |
Total of all active and inactive participants | 2013-05-01 | 105 |
Total participants | 2013-05-01 | 105 |
2012: SIEMER MILLING COMPANY HEALTH CARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-05-01 | 106 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 111 |
Total of all active and inactive participants | 2012-05-01 | 111 |
Total participants | 2012-05-01 | 111 |
2011: SIEMER MILLING COMPANY HEALTH CARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-05-01 | 103 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 106 |
Total of all active and inactive participants | 2011-05-01 | 106 |
Total participants | 2011-05-01 | 106 |
2009: SIEMER MILLING COMPANY HEALTH CARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-05-01 | 118 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 121 |
Total of all active and inactive participants | 2009-05-01 | 121 |
Total participants | 2009-05-01 | 121 |
2022: SIEMER MILLING COMPANY HEALTH CARE PLAN 2022 form 5500 responses |
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2022-05-01 | Type of plan entity | Single employer plan |
2022-05-01 | Submission has been amended | No |
2022-05-01 | This submission is the final filing | No |
2022-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-05-01 | Plan is a collectively bargained plan | No |
2022-05-01 | Plan funding arrangement – Insurance | Yes |
2022-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-05-01 | Plan benefit arrangement – Insurance | Yes |
2022-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: SIEMER MILLING COMPANY HEALTH CARE PLAN 2021 form 5500 responses |
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2021-05-01 | Type of plan entity | Single employer plan |
2021-05-01 | Submission has been amended | No |
2021-05-01 | This submission is the final filing | No |
2021-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-05-01 | Plan is a collectively bargained plan | No |
2021-05-01 | Plan funding arrangement – Insurance | Yes |
2021-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-05-01 | Plan benefit arrangement – Insurance | Yes |
2021-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: SIEMER MILLING COMPANY HEALTH CARE PLAN 2020 form 5500 responses |
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2020-05-01 | Type of plan entity | Single employer plan |
2020-05-01 | Submission has been amended | No |
2020-05-01 | This submission is the final filing | No |
2020-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-05-01 | Plan is a collectively bargained plan | No |
2020-05-01 | Plan funding arrangement – Insurance | Yes |
2020-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-05-01 | Plan benefit arrangement – Insurance | Yes |
2020-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: SIEMER MILLING COMPANY HEALTH CARE PLAN 2019 form 5500 responses |
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2019-05-01 | Type of plan entity | Single employer plan |
2019-05-01 | Submission has been amended | No |
2019-05-01 | This submission is the final filing | No |
2019-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-05-01 | Plan is a collectively bargained plan | No |
2019-05-01 | Plan funding arrangement – Insurance | Yes |
2019-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-05-01 | Plan benefit arrangement – Insurance | Yes |
2019-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: SIEMER MILLING COMPANY HEALTH CARE PLAN 2018 form 5500 responses |
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2018-05-01 | Type of plan entity | Single employer plan |
2018-05-01 | Submission has been amended | No |
2018-05-01 | This submission is the final filing | No |
2018-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-05-01 | Plan is a collectively bargained plan | No |
2018-05-01 | Plan funding arrangement – Insurance | Yes |
2018-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-05-01 | Plan benefit arrangement – Insurance | Yes |
2018-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: SIEMER MILLING COMPANY HEALTH CARE PLAN 2017 form 5500 responses |
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2017-05-01 | Type of plan entity | Single employer plan |
2017-05-01 | Submission has been amended | No |
2017-05-01 | This submission is the final filing | No |
2017-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-05-01 | Plan is a collectively bargained plan | No |
2017-05-01 | Plan funding arrangement – Insurance | Yes |
2017-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-05-01 | Plan benefit arrangement – Insurance | Yes |
2017-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: SIEMER MILLING COMPANY HEALTH CARE PLAN 2016 form 5500 responses |
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2016-05-01 | Type of plan entity | Single employer plan |
2016-05-01 | Submission has been amended | No |
2016-05-01 | This submission is the final filing | No |
2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-05-01 | Plan is a collectively bargained plan | No |
2016-05-01 | Plan funding arrangement – Insurance | Yes |
2016-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-05-01 | Plan benefit arrangement – Insurance | Yes |
2016-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: SIEMER MILLING COMPANY HEALTH CARE PLAN 2015 form 5500 responses |
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2015-05-01 | Type of plan entity | Single employer plan |
2015-05-01 | Submission has been amended | No |
2015-05-01 | This submission is the final filing | No |
2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-05-01 | Plan is a collectively bargained plan | No |
2015-05-01 | Plan funding arrangement – Insurance | Yes |
2015-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-05-01 | Plan benefit arrangement – Insurance | Yes |
2015-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: SIEMER MILLING COMPANY HEALTH CARE PLAN 2014 form 5500 responses |
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2014-05-01 | Type of plan entity | Single employer plan |
2014-05-01 | Submission has been amended | No |
2014-05-01 | This submission is the final filing | No |
2014-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-05-01 | Plan is a collectively bargained plan | No |
2014-05-01 | Plan funding arrangement – Insurance | Yes |
2014-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-05-01 | Plan benefit arrangement – Insurance | Yes |
2014-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: SIEMER MILLING COMPANY HEALTH CARE PLAN 2013 form 5500 responses |
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2013-05-01 | Type of plan entity | Single employer plan |
2013-05-01 | Submission has been amended | No |
2013-05-01 | This submission is the final filing | No |
2013-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-05-01 | Plan is a collectively bargained plan | No |
2013-05-01 | Plan funding arrangement – Insurance | Yes |
2013-05-01 | Plan benefit arrangement – Insurance | Yes |
2012: SIEMER MILLING COMPANY HEALTH CARE PLAN 2012 form 5500 responses |
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2012-05-01 | Type of plan entity | Single employer plan |
2012-05-01 | Submission has been amended | No |
2012-05-01 | This submission is the final filing | No |
2012-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-05-01 | Plan is a collectively bargained plan | No |
2012-05-01 | Plan funding arrangement – Insurance | Yes |
2012-05-01 | Plan benefit arrangement – Insurance | Yes |
2011: SIEMER MILLING COMPANY HEALTH CARE PLAN 2011 form 5500 responses |
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2011-05-01 | Type of plan entity | Single employer plan |
2011-05-01 | Submission has been amended | No |
2011-05-01 | This submission is the final filing | No |
2011-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-05-01 | Plan is a collectively bargained plan | No |
2011-05-01 | Plan funding arrangement – Insurance | Yes |
2011-05-01 | Plan benefit arrangement – Insurance | Yes |
2009: SIEMER MILLING COMPANY HEALTH CARE PLAN 2009 form 5500 responses |
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2009-05-01 | Type of plan entity | Single employer plan |
2009-05-01 | Submission has been amended | No |
2009-05-01 | This submission is the final filing | No |
2009-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-05-01 | Plan is a collectively bargained plan | No |
2009-05-01 | Plan funding arrangement – Insurance | Yes |
2009-05-01 | Plan benefit arrangement – Insurance | Yes |
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
Policy contract number | GL-0114-VU |
Policy instance | 1 |
Insurance contract or identification number | GL-0114-VU | Number of Individuals Covered | 147 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2023-04-30 | Total amount of commissions paid to insurance broker | USD $12,845 | 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 $282,429 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,845 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 |
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GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
Policy contract number | |
Policy instance | 1 |
Number of Individuals Covered | 151 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $12,629 | Total amount of fees paid to insurance company | USD $56,095 | 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 $12,629 | Amount paid for insurance broker fees | 56095 | Additional information about fees paid to insurance broker | ADMINISTRATION, PPO/UR SERVICES, PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | |
Policy instance | 1 |
Number of Individuals Covered | 151 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $12,998 | Total amount of fees paid to insurance company | USD $53,736 | 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 $12,999 | Amount paid for insurance broker fees | 53736 | Additional information about fees paid to insurance broker | ADMINISTRATION, PPO/UR SERVICES, PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 4068630010SSLS |
Policy instance | 1 |
Insurance contract or identification number | 4068630010SSLS | Number of Individuals Covered | 152 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $23,590 | Total amount of fees paid to insurance company | USD $51,477 | 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 $23,590 | Amount paid for insurance broker fees | 51477 | Additional information about fees paid to insurance broker | ADMINISTRATION, PPO/UR SERVICES, PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 4068630010SSLS |
Policy instance | 1 |
Insurance contract or identification number | 4068630010SSLS | Number of Individuals Covered | 159 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $18,660 | Total amount of fees paid to insurance company | USD $51,035 | 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 $18,660 | Amount paid for insurance broker fees | 51035 | Additional information about fees paid to insurance broker | ADMINISTRATION ,PPO/UR SERVICES,PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 |
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IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | ERR000000235-01 |
Policy instance | 1 |
Insurance contract or identification number | ERR000000235-01 | Number of Individuals Covered | 153 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-05-01 | Total amount of commissions paid to insurance broker | USD $16,059 | Total amount of fees paid to insurance company | USD $50,154 | 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 $16,059 | Amount paid for insurance broker fees | 50154 | Additional information about fees paid to insurance broker | ADMINISTRATION,PPO/UR SERVICES,PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 | Insurance broker name | DANSIG, INC. |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 4052000010SSLS |
Policy instance | 1 |
Insurance contract or identification number | 4052000010SSLS | Number of Individuals Covered | 142 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $15,463 | Total amount of fees paid to insurance company | USD $42,513 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,463 | Amount paid for insurance broker fees | 42513 | Additional information about fees paid to insurance broker | ADMINISTRATION, PPO/UR SERVICES, PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 | Insurance broker name | DANSIG, INC. |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 4052000010SSLS |
Policy instance | 1 |
Insurance contract or identification number | 4052000010SSLS | Number of Individuals Covered | 123 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $10,915 | Total amount of fees paid to insurance company | USD $34,064 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,914 | Amount paid for insurance broker fees | 34064 | Additional information about fees paid to insurance broker | ADMINISTRATION, PPO/UR SERVICES, PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 | Insurance broker name | DANSIG INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | SE4E50023 |
Policy instance | 1 |
Insurance contract or identification number | SE4E50023 | Number of Individuals Covered | 105 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $9,838 | Total amount of fees paid to insurance company | USD $29,561 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,838 | Amount paid for insurance broker fees | 29561 | Additional information about fees paid to insurance broker | ADMINISTRATION, PPO/UR SERVICES, PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 | Insurance broker name | CONSOCIATE DANSIG INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | SE4E50023 |
Policy instance | 1 |
Insurance contract or identification number | SE4E50023 | Number of Individuals Covered | 111 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $9,070 | Total amount of fees paid to insurance company | USD $27,412 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,070 | Amount paid for insurance broker fees | 27412 | Additional information about fees paid to insurance broker | ADMINISTRATION, PPO/UR SERVICES, PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 | Insurance broker name | CONSOCIATE DANSIG INC. |
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MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 ) |
Policy contract number | 98217 |
Policy instance | 1 |
Insurance contract or identification number | 98217 | Number of Individuals Covered | 106 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $7,536 | Total amount of fees paid to insurance company | USD $27,359 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 ) |
Policy contract number | 98217 |
Policy instance | 1 |
Insurance contract or identification number | 98217 | Number of Individuals Covered | 103 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $7,559 | Total amount of fees paid to insurance company | USD $29,246 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,559 | Amount paid for insurance broker fees | 29246 | Additional information about fees paid to insurance broker | ADMINISTRATION, PPO/UR SERVICES PPO/UR ADMINISTRATION | Insurance broker organization code? | 5 | Insurance broker name | CONSOCIATE DANSIG INC. |
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