POWDER COTE II has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan POWDER COTE II PREMIUM CONVERSION PLAN
Measure | Date | Value |
---|
2022: POWDER COTE II PREMIUM CONVERSION PLAN 2022 401k membership |
---|
Total participants, beginning-of-year | 2022-01-01 | 226 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 295 |
Total of all active and inactive participants | 2022-01-01 | 295 |
2021: POWDER COTE II PREMIUM CONVERSION PLAN 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-01-01 | 262 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 226 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 226 |
2020: POWDER COTE II PREMIUM CONVERSION PLAN 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-01-01 | 259 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 262 |
Total of all active and inactive participants | 2020-01-01 | 262 |
2019: POWDER COTE II PREMIUM CONVERSION PLAN 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-01-01 | 264 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 259 |
Total of all active and inactive participants | 2019-01-01 | 259 |
2018: POWDER COTE II PREMIUM CONVERSION PLAN 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-01-01 | 303 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 264 |
Total of all active and inactive participants | 2018-01-01 | 264 |
2017: POWDER COTE II PREMIUM CONVERSION PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-01-01 | 298 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 303 |
Total of all active and inactive participants | 2017-01-01 | 303 |
2016: POWDER COTE II PREMIUM CONVERSION PLAN 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-01-01 | 301 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 298 |
Total of all active and inactive participants | 2016-01-01 | 298 |
2015: POWDER COTE II PREMIUM CONVERSION PLAN 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-01-01 | 327 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 301 |
Total of all active and inactive participants | 2015-01-01 | 301 |
2014: POWDER COTE II PREMIUM CONVERSION PLAN 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-01-01 | 309 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 327 |
Total of all active and inactive participants | 2014-01-01 | 327 |
2013: POWDER COTE II PREMIUM CONVERSION PLAN 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-01-01 | 331 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 309 |
Total of all active and inactive participants | 2013-01-01 | 309 |
2012: POWDER COTE II PREMIUM CONVERSION PLAN 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-01-01 | 223 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 331 |
Total of all active and inactive participants | 2012-01-01 | 331 |
2011: POWDER COTE II PREMIUM CONVERSION PLAN 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-01-01 | 188 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 223 |
Total of all active and inactive participants | 2011-01-01 | 223 |
2009: POWDER COTE II PREMIUM CONVERSION PLAN 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-01-01 | 147 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 105 |
Total of all active and inactive participants | 2009-01-01 | 105 |
2022: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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: POWDER COTE II PREMIUM CONVERSION 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 |
2009: POWDER COTE II PREMIUM CONVERSION PLAN 2009 form 5500 responses |
---|
2009-01-01 | Type of plan entity | Single employer plan |
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 |
REGENCY EMPLOYEE BENEFITS (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 79018 / 671 |
Policy instance | 2 |
Insurance contract or identification number | 79018 / 671 | Number of Individuals Covered | 96 | 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 $46,464 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $647,724 | 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 | 46464 | Additional information about fees paid to insurance broker | ADMINISTRATION FEES | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BMM7 |
Policy instance | 1 |
Insurance contract or identification number | G000BMM7 | Number of Individuals Covered | 295 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,678 | Total amount of fees paid to insurance company | USD $1,718 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $20,978 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,678 | Amount paid for insurance broker fees | 669 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BMM7 |
Policy instance | 1 |
Insurance contract or identification number | G000BMM7 | Number of Individuals Covered | 226 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,530 | Total amount of fees paid to insurance company | USD $1,141 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $19,126 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,530 | Amount paid for insurance broker fees | 1141 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
REGENCY EMPLOYEE BENEFITS (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 79018 / 671 |
Policy instance | 2 |
Insurance contract or identification number | 79018 / 671 | Number of Individuals Covered | 97 | 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 $46,464 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $720,368 | 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 | 46464 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 |
|
REGENCY EMPLOYEE BENEFITS (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 79018 / 671 |
Policy instance | 2 |
Insurance contract or identification number | 79018 / 671 | Number of Individuals Covered | 111 | 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 $46,464 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $772,652 | 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 | 46464 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BMM7 |
Policy instance | 1 |
Insurance contract or identification number | G000BMM7 | 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 $1,702 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $21,275 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,702 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
REGENCY EMPLOYEE BENEFITS (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 79018 / 671 |
Policy instance | 2 |
Insurance contract or identification number | 79018 / 671 | Number of Individuals Covered | 114 | 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 $46,464 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $735,969 | 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 | 46464 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05925674 |
Policy instance | 1 |
Insurance contract or identification number | TM05925674 | Number of Individuals Covered | 259 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,598 | Total amount of fees paid to insurance company | USD $148 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $17,226 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,598 | Amount paid for insurance broker fees | 148 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05925674 |
Policy instance | 1 |
Insurance contract or identification number | TM05925674 | Number of Individuals Covered | 303 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,705 | Total amount of fees paid to insurance company | USD $785 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $19,141 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,705 | Amount paid for insurance broker fees | 785 | Additional information about fees paid to insurance broker | SUPPLEMENTAL AND NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ACRISURE LLC |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05925674 |
Policy instance | 1 |
Insurance contract or identification number | TM05925674 | Number of Individuals Covered | 301 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,645 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $19,412 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,645 | Insurance broker organization code? | 3 | Insurance broker name | ACRISURE LLC |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AHQR |
Policy instance | 2 |
Insurance contract or identification number | GVTL0AHQR | Number of Individuals Covered | 31 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $1,069 | Total amount of fees paid to insurance company | USD $187 | 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 | AD&D - VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $7,125 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,069 | Amount paid for insurance broker fees | 187 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ACRISURE LLC |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AHQR |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AHQR | Number of Individuals Covered | 327 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $2,863 | Total amount of fees paid to insurance company | USD $692 | 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 | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,632 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,863 | Amount paid for insurance broker fees | 692 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ACRISURE LLC |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AHQR |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AHQR | Number of Individuals Covered | 309 | Insurance policy start date | 2012-12-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $2,868 | 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 | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,678 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,868 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ACRISURE LLC |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AHQR |
Policy instance | 2 |
Insurance contract or identification number | GVTL0AHQR | Number of Individuals Covered | 32 | Insurance policy start date | 2012-12-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $1,191 | 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 | AD&D - VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $7,936 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,191 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ACRISURE LLC |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHQR |
Policy instance | 2 |
Insurance contract or identification number | G000AHQR | Number of Individuals Covered | 38 | Insurance policy start date | 2011-12-01 | Insurance policy end date | 2012-12-01 | Total amount of commissions paid to insurance broker | USD $1,845 | 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 | AD&D - VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $8,445 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,845 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ACRISURE LLC |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHQR |
Policy instance | 1 |
Insurance contract or identification number | G000AHQR | Number of Individuals Covered | 331 | Insurance policy start date | 2011-12-01 | Insurance policy end date | 2012-12-01 | Total amount of commissions paid to insurance broker | USD $3,834 | 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 | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $26,664 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,834 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ACRISURE LLC |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689934G |
Policy instance | 2 |
Insurance contract or identification number | 689934G | Number of Individuals Covered | 223 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $544 | 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 | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $2,722 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ADDS05318 |
Policy instance | 1 |
Insurance contract or identification number | ADDS05318 | Number of Individuals Covered | 223 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $110 | 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 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $737 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 10694 |
Policy instance | 3 |
Insurance contract or identification number | 10694 | Number of Individuals Covered | 206 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $16,949 | 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 | Health Insurance Welfare Benefit | Yes | Were dividends or retroactive rate refunds paid in cash? | 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 $16,949 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ROBBINS & MARCOZZI, INC. |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689934G |
Policy instance | 2 |
Insurance contract or identification number | 689934G | Number of Individuals Covered | 188 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $6,144 | 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 | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $32,507 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,144 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ROBBINS & MARCOZZI, INC. |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ADDS05318 |
Policy instance | 1 |
Insurance contract or identification number | ADDS05318 | Number of Individuals Covered | 188 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $679 | 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 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $4,525 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $679 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ROBBINS & MARCOZZI, INC. |
|