MEMORIAL HEALTH SYSTEM has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN
401k plan membership statisitcs for MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN
| Measure | Date | Value |
|---|
| 2022: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 7,135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 7,063 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 81 |
| Total of all active and inactive participants | 2022-01-01 | 7,144 |
| 2021: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 6,834 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 7,088 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 47 |
| Total of all active and inactive participants | 2021-01-01 | 7,135 |
| 2020: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 5,506 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 5,120 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 51 |
| Total of all active and inactive participants | 2020-01-01 | 5,171 |
| 2019: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 4,334 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 4,197 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 28 |
| Total of all active and inactive participants | 2019-01-01 | 4,225 |
| 2018: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 5,051 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 4,902 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 47 |
| Total of all active and inactive participants | 2018-01-01 | 4,949 |
| 2017: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 5,160 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 5,010 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 62 |
| Total of all active and inactive participants | 2017-01-01 | 5,072 |
| 2016: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 5,523 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 5,522 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 43 |
| Total of all active and inactive participants | 2016-01-01 | 5,565 |
| 2015: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 4,263 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 4,709 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 38 |
| Total of all active and inactive participants | 2015-01-01 | 4,747 |
| 2014: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 4,574 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 4,674 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 38 |
| Total of all active and inactive participants | 2014-01-01 | 4,712 |
| 2013: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 4,511 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 4,511 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 63 |
| Total of all active and inactive participants | 2013-01-01 | 4,574 |
| 2012: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 4,511 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 4,450 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 61 |
| Total of all active and inactive participants | 2012-01-01 | 4,511 |
| 2011: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 4,530 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 4,446 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 65 |
| Total of all active and inactive participants | 2011-01-01 | 4,511 |
| 2010: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 4,388 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 4,449 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 81 |
| Total of all active and inactive participants | 2010-01-01 | 4,530 |
| 2009: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 4,073 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 4,185 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 69 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 4,254 |
| 2022: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | Yes |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HARTFORD LIFE AND ACCIDENT (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681832G |
| Policy instance | 3 |
| Insurance contract or identification number | 681832G | | Number of Individuals Covered | 17969 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $524,532 | | Total amount of fees paid to insurance company | USD $124,218 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,885,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $398,814 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 97630 | | Additional information about fees paid to insurance broker | SERVICE FEES |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 9920257 |
| Policy instance | 2 |
| Insurance contract or identification number | 9920257 | | Number of Individuals Covered | 10435 | | 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 $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $440,418 | | 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 | 0229054 |
| Policy instance | 1 |
| Insurance contract or identification number | 0229054 | | Number of Individuals Covered | 13075 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $368,373 | | Total amount of fees paid to insurance company | USD $68,381 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,858,076 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $368,373 | | Amount paid for insurance broker fees | 68305 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL AND NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681832G |
| Policy instance | 3 |
| Insurance contract or identification number | 681832G | | Number of Individuals Covered | 9133 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,069,710 | | Total amount of fees paid to insurance company | USD $157,693 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,660,261 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $455,578 | | Amount paid for insurance broker fees | 76027 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | BONUS PAID |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 9920257 |
| Policy instance | 2 |
| Insurance contract or identification number | 9920257 | | Number of Individuals Covered | 10560 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $474,961 | | 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 | 0229054 |
| Policy instance | 1 |
| Insurance contract or identification number | 0229054 | | Number of Individuals Covered | 12794 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $231,486 | | Total amount of fees paid to insurance company | USD $92 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,710,328 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $231,486 | | Amount paid for insurance broker fees | 54 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 9920257 |
| Policy instance | 1 |
| Insurance contract or identification number | 9920257 | | Number of Individuals Covered | 8111 | | 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 $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $421,773 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 68498-8 |
| Policy instance | 2 |
| Insurance contract or identification number | 68498-8 | | Number of Individuals Covered | 6984 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $324,149 | | Total amount of fees paid to insurance company | USD $4,217 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,498,546 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $200,921 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 4217 | | Additional information about fees paid to insurance broker | SERVICE FEE |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 804449G |
| Policy instance | 3 |
| Insurance contract or identification number | 804449G | | Number of Individuals Covered | 5181 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $159,805 | | Total amount of fees paid to insurance company | USD $79,467 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,152,772 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $159,805 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 79467 | | Additional information about fees paid to insurance broker | CONTINGENT FEES |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 804449G |
| Policy instance | 4 |
| Insurance contract or identification number | 804449G | | Number of Individuals Covered | 5680 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $58,491 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $777,372 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $58,491 | | Insurance broker organization code? | 3 |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 68498-8 |
| Policy instance | 3 |
| Insurance contract or identification number | 68498-8 | | Number of Individuals Covered | 7089 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $372,601 | | Total amount of fees paid to insurance company | USD $6,600 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,500,979 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $219,286 | | Additional information about fees paid to insurance broker | WRITING AGENT AND SUPP COMPENSATION | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6600 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 9920257 |
| Policy instance | 2 |
| Insurance contract or identification number | 9920257 | | Number of Individuals Covered | 8599 | | 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 $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $498,201 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0283685-SHORT |
| Policy instance | 1 |
| Insurance contract or identification number | 0283685-SHORT | | Number of Individuals Covered | 5646 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-07-31 | | Total amount of commissions paid to insurance broker | USD $83,785 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,384,746 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $83,785 | | Insurance broker organization code? | 3 |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 68498-8 |
| Policy instance | 3 |
| Insurance contract or identification number | 68498-8 | | Number of Individuals Covered | 11843 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $342,396 | | Total amount of fees paid to insurance company | USD $6,783 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,175,304 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $195,659 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6783 | | Additional information about fees paid to insurance broker | SERVICE FEE |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 9920257 |
| Policy instance | 2 |
| Insurance contract or identification number | 9920257 | | Number of Individuals Covered | 7481 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $365,977 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0283685 |
| Policy instance | 1 |
| Insurance contract or identification number | 0283685 | | Number of Individuals Covered | 5042 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $269,572 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,062,264 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $269,572 | | Insurance broker organization code? | 3 |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 68498-8 |
| Policy instance | 3 |
| Insurance contract or identification number | 68498-8 | | Number of Individuals Covered | 9505 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $306,054 | | Total amount of fees paid to insurance company | USD $6,783 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $878,297 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $161,189 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6783 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker name | BIGGIN CONSULTING SERVICES LLC |
|
| RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 61360 ) |
| Policy contract number | 68498-8 |
| Policy instance | 4 |
| Insurance contract or identification number | 68498-8 | | Number of Individuals Covered | 2200 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $246,668 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $769,413 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $123,334 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKTON COMPANIES, LLC |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 9920257 |
| Policy instance | 2 |
| Insurance contract or identification number | 9920257 | | Number of Individuals Covered | 7524 | | 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 $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $393,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0283685 |
| Policy instance | 1 |
| Insurance contract or identification number | 0283685 | | Number of Individuals Covered | 5083 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $90,977 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,045,753 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $90,977 | | Insurance broker organization code? | 3 | | Insurance broker name | VHA MID-AMERICA INSURANCE SERVICES |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010144953 00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010144953 00 | | Number of Individuals Covered | 4456 | | Insurance policy start date | 2015-10-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,360 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010165408 00 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010165408 00 | | Number of Individuals Covered | 5147 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $17,814 | | Total amount of fees paid to insurance company | USD $10,000 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $356,289 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,814 | | Amount paid for insurance broker fees | 10000 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | VHA MID AMERICA INS SVCS |
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0283685-SHORT |
| Policy instance | 3 |
| Insurance contract or identification number | 0283685-SHORT | | Number of Individuals Covered | 10126 | | Insurance policy start date | 2015-12-01 | | 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 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $107,666 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400001000 18 |
| Policy instance | 4 |
| Insurance contract or identification number | 000400001000 18 | | Number of Individuals Covered | 3081 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $87,774 | | Total amount of fees paid to insurance company | USD $25,000 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $877,737 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $87,774 | | Amount paid for insurance broker fees | 25000 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | VHA MID AMERICA INS SVCS |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010144953 00 |
| Policy instance | 5 |
| Insurance contract or identification number | 000010144953 00 | | Number of Individuals Covered | 4496 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $8,542 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $357,207 | | 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 | 8542 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | VHA MID AMERICA INS SVCS |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010144953 00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010144953 00 | | Number of Individuals Covered | 3993 | | 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 $19,574 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $427,111 | | 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 | 19574 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | VHA MID AMERICA INS SVCS |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010165408 00 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010165408 00 | | Number of Individuals Covered | 4660 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $65,561 | | Total amount of fees paid to insurance company | USD $22,500 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,311,226 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $65,561 | | Amount paid for insurance broker fees | 22500 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | VHA MID AMERICA INS SVCS |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010165408 00 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010165408 00 | | Number of Individuals Covered | 4567 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $32,012 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,238,029 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,012 | | Insurance broker organization code? | 3 | | Insurance broker name | VHA MID AMERICA INS SVCS |
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 473231 |
| Policy instance | 1 |
| Insurance contract or identification number | 473231 | | Number of Individuals Covered | 7003 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $127,517 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,280,543 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $127,517 | | Insurance broker organization code? | 3 | | Insurance broker name | VHA MID AMERICA INSURANCE SERVICES |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 473231 |
| Policy instance | 1 |
| Insurance contract or identification number | 473231 | | Number of Individuals Covered | 6313 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $130,748 | | Total amount of fees paid to insurance company | USD $30,000 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,216,831 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 473231 |
| Policy instance | 1 |
| Insurance contract or identification number | 473231 | | Number of Individuals Covered | 7070 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $96,635 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH-DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,155,675 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $96,635 | | Insurance broker organization code? | 3 | | Insurance broker name | VHA MID-AMERICA INSURANCE SERVICES |
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