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KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 401k Plan overview

Plan NameKNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST
Plan identification number 501

KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

VERNE C. KNIGHT TRUST has sponsored the creation of one or more 401k plans.

Company Name:VERNE C. KNIGHT TRUST
Employer identification number (EIN):386809442
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01JEFFREY C JABLONSKI2023-10-02
5012021-01-01NORMAN J GLASSER2022-09-09
5012020-01-01NORMAN J GLASSER2021-06-23 NORMAN J GLASSER2021-06-23
5012019-01-01NORMAN J GLASSER2020-06-02 NORMAN J GLASSER2020-06-02
5012018-01-01NORMAN J GLASSER2019-08-04 NORMAN J GLASSER2019-08-04
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01NORMAN J. GLASSER
5012011-01-01NORMAN J. GLASSER
5012010-01-01NORMAN J. GLASSER
5012009-01-01NORMAN J. GLASSER

Plan Statistics for KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST

401k plan membership statisitcs for KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST

Measure Date Value
2022: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2022 401k membership
Total participants, beginning-of-year2022-01-012
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-011
2021: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2021 401k membership
Total participants, beginning-of-year2021-01-012
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-012
Total participants2021-01-012
2020: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-012
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-012
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-012
Total participants2020-01-012
2019: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-014
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-012
2018: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-015
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-014
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-014
2017: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-016
Number of retired or separated participants receiving benefits2017-01-015
Total of all active and inactive participants2017-01-015
2016: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-018
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-016
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-016
2015: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-0112
Number of retired or separated participants receiving benefits2015-01-018
Total of all active and inactive participants2015-01-018
2014: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-0119
Number of retired or separated participants receiving benefits2014-01-0112
Total of all active and inactive participants2014-01-0112
2013: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-0122
Number of retired or separated participants receiving benefits2013-01-0119
Total of all active and inactive participants2013-01-0119
2012: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-0127
Number of retired or separated participants receiving benefits2012-01-0122
Total of all active and inactive participants2012-01-0122
2011: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-0129
Number of retired or separated participants receiving benefits2011-01-0127
Total of all active and inactive participants2011-01-0127
2010: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-0136
Number of retired or separated participants receiving benefits2010-01-0129
Total of all active and inactive participants2010-01-0129
2009: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-0136
Number of retired or separated participants receiving benefits2009-01-0136
Total of all active and inactive participants2009-01-0136

Financial Data on KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST

Measure Date Value
2022 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2022 401k financial data
Total income from all sources2022-12-31$16,631
Expenses. Total of all expenses incurred2022-12-31$38,828
Benefits paid (including direct rollovers)2022-12-31$15,906
Total plan assets at end of year2022-12-31$1,637,147
Total plan assets at beginning of year2022-12-31$1,659,344
Value of fidelity bond covering the plan2022-12-31$500,000
Expenses. Other expenses not covered elsewhere2022-12-31$16,500
Other income received2022-12-31$16,631
Net income (gross income less expenses)2022-12-31$-22,197
Net plan assets at end of year (total assets less liabilities)2022-12-31$1,637,147
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,659,344
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$6,422
2021 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2021 401k financial data
Total income from all sources2021-12-31$23,234
Expenses. Total of all expenses incurred2021-12-31$39,327
Benefits paid (including direct rollovers)2021-12-31$16,056
Total plan assets at end of year2021-12-31$1,659,344
Total plan assets at beginning of year2021-12-31$1,675,437
Value of fidelity bond covering the plan2021-12-31$500,000
Expenses. Other expenses not covered elsewhere2021-12-31$16,500
Other income received2021-12-31$23,234
Net income (gross income less expenses)2021-12-31$-16,093
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,659,344
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,675,437
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$6,771
2020 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2020 401k financial data
Total income from all sources2020-12-31$42,086
Expenses. Total of all expenses incurred2020-12-31$46,995
Benefits paid (including direct rollovers)2020-12-31$15,599
Total plan assets at end of year2020-12-31$1,675,437
Total plan assets at beginning of year2020-12-31$1,680,346
Value of fidelity bond covering the plan2020-12-31$500,000
Expenses. Other expenses not covered elsewhere2020-12-31$17,500
Other income received2020-12-31$42,086
Net income (gross income less expenses)2020-12-31$-4,909
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,675,437
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,680,346
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$13,896
2019 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2019 401k financial data
Total income from all sources2019-12-31$45,605
Expenses. Total of all expenses incurred2019-12-31$55,726
Benefits paid (including direct rollovers)2019-12-31$24,407
Total plan assets at end of year2019-12-31$1,680,346
Total plan assets at beginning of year2019-12-31$1,690,467
Value of fidelity bond covering the plan2019-12-31$500,000
Expenses. Other expenses not covered elsewhere2019-12-31$22,500
Other income received2019-12-31$45,605
Net income (gross income less expenses)2019-12-31$-10,121
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,680,346
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,690,467
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$8,819
2018 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2018 401k financial data
Total income from all sources2018-12-31$45,221
Expenses. Total of all expenses incurred2018-12-31$57,934
Benefits paid (including direct rollovers)2018-12-31$30,401
Total plan assets at end of year2018-12-31$1,690,467
Total plan assets at beginning of year2018-12-31$1,703,180
Value of fidelity bond covering the plan2018-12-31$500,000
Expenses. Other expenses not covered elsewhere2018-12-31$500
Other income received2018-12-31$45,221
Net income (gross income less expenses)2018-12-31$-12,713
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,690,467
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,703,180
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$27,033
2017 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2017 401k financial data
Total income from all sources2017-12-31$44,913
Expenses. Total of all expenses incurred2017-12-31$64,145
Benefits paid (including direct rollovers)2017-12-31$34,848
Total plan assets at end of year2017-12-31$1,703,179
Total plan assets at beginning of year2017-12-31$1,722,411
Value of fidelity bond covering the plan2017-12-31$500,000
Expenses. Other expenses not covered elsewhere2017-12-31$2,304
Other income received2017-12-31$44,913
Net income (gross income less expenses)2017-12-31$-19,232
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,703,179
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,722,411
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$26,993
2016 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2016 401k financial data
Total income from all sources2016-12-31$45,983
Expenses. Total of all expenses incurred2016-12-31$67,233
Benefits paid (including direct rollovers)2016-12-31$32,507
Total plan assets at end of year2016-12-31$1,722,411
Total plan assets at beginning of year2016-12-31$1,743,661
Value of fidelity bond covering the plan2016-12-31$500,000
Expenses. Other expenses not covered elsewhere2016-12-31$2,500
Other income received2016-12-31$45,983
Net income (gross income less expenses)2016-12-31$-21,250
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,722,411
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,743,661
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$32,226
2015 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2015 401k financial data
Total income from all sources2015-12-31$53,855
Expenses. Total of all expenses incurred2015-12-31$83,879
Benefits paid (including direct rollovers)2015-12-31$50,306
Total plan assets at end of year2015-12-31$1,743,661
Total plan assets at beginning of year2015-12-31$1,773,685
Value of fidelity bond covering the plan2015-12-31$500,000
Expenses. Other expenses not covered elsewhere2015-12-31$2,500
Other income received2015-12-31$53,855
Net income (gross income less expenses)2015-12-31$-30,024
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,743,661
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,773,685
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$31,073
2014 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2014 401k financial data
Total income from all sources2014-12-31$56,421
Expenses. Total of all expenses incurred2014-12-31$154,150
Benefits paid (including direct rollovers)2014-12-31$118,967
Total plan assets at end of year2014-12-31$1,773,685
Total plan assets at beginning of year2014-12-31$1,871,414
Value of fidelity bond covering the plan2014-12-31$500,000
Expenses. Other expenses not covered elsewhere2014-12-31$2,500
Other income received2014-12-31$56,421
Net income (gross income less expenses)2014-12-31$-97,729
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,773,685
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,871,414
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$32,683
2013 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2013 401k financial data
Total income from all sources2013-12-31$64,536
Expenses. Total of all expenses incurred2013-12-31$167,449
Benefits paid (including direct rollovers)2013-12-31$130,748
Total plan assets at end of year2013-12-31$1,871,414
Total plan assets at beginning of year2013-12-31$1,974,327
Value of fidelity bond covering the plan2013-12-31$500,000
Expenses. Other expenses not covered elsewhere2013-12-31$2,500
Other income received2013-12-31$64,536
Net income (gross income less expenses)2013-12-31$-102,913
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,871,414
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,974,327
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$34,201
2012 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2012 401k financial data
Total income from all sources2012-12-31$135,491
Expenses. Total of all expenses incurred2012-12-31$195,528
Benefits paid (including direct rollovers)2012-12-31$157,459
Total plan assets at end of year2012-12-31$1,974,327
Total plan assets at beginning of year2012-12-31$2,034,364
Value of fidelity bond covering the plan2012-12-31$500,000
Expenses. Other expenses not covered elsewhere2012-12-31$2,500
Other income received2012-12-31$135,491
Net income (gross income less expenses)2012-12-31$-60,037
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,974,327
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$2,034,364
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$35,569
2011 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2011 401k financial data
Total income from all sources2011-12-31$89,911
Expenses. Total of all expenses incurred2011-12-31$181,857
Benefits paid (including direct rollovers)2011-12-31$145,391
Total plan assets at end of year2011-12-31$2,034,364
Total plan assets at beginning of year2011-12-31$2,126,310
Value of fidelity bond covering the plan2011-12-31$2,000,000
Other income received2011-12-31$89,911
Net income (gross income less expenses)2011-12-31$-91,946
Net plan assets at end of year (total assets less liabilities)2011-12-31$2,034,364
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$2,126,310
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$36,466
2010 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2010 401k financial data
Total plan liabilities at beginning of year2010-12-31$39,773
Total income from all sources2010-12-31$93,276
Expenses. Total of all expenses incurred2010-12-31$203,128
Benefits paid (including direct rollovers)2010-12-31$166,337
Total plan assets at end of year2010-12-31$2,126,310
Total plan assets at beginning of year2010-12-31$2,275,935
Value of fidelity bond covering the plan2010-12-31$2,000,000
Other income received2010-12-31$93,276
Net income (gross income less expenses)2010-12-31$-109,852
Net plan assets at end of year (total assets less liabilities)2010-12-31$2,126,310
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$2,236,162
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$36,791

Form 5500 Responses for KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST

2022: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number
Policy instance 2
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $110
Welfare Benefit Premiums Paid to CarrierUSD $9,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $110
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberAGP-3888
Policy instance 1
Insurance contract or identification numberAGP-3888
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $403
Welfare Benefit Premiums Paid to CarrierUSD $5,988
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $403
Insurance broker organization code?3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number
Policy instance 2
Number of Individuals Covered2
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $120
Welfare Benefit Premiums Paid to CarrierUSD $9,696
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $120
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberAGP-3888
Policy instance 1
Insurance contract or identification numberAGP-3888
Number of Individuals Covered2
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $425
Welfare Benefit Premiums Paid to CarrierUSD $6,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $425
Insurance broker organization code?3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number
Policy instance 2
Number of Individuals Covered2
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $120
Welfare Benefit Premiums Paid to CarrierUSD $9,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $120
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberAGP-3888
Policy instance 1
Insurance contract or identification numberAGP-3888
Number of Individuals Covered2
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $405
Welfare Benefit Premiums Paid to CarrierUSD $6,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $405
Insurance broker organization code?3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number
Policy instance 2
Number of Individuals Covered2
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $135
Welfare Benefit Premiums Paid to CarrierUSD $9,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $135
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberAGP-3888
Policy instance 1
Insurance contract or identification numberAGP-3888
Number of Individuals Covered2
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $611
Welfare Benefit Premiums Paid to CarrierUSD $9,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $611
Insurance broker organization code?3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract numberBXMA
Policy instance 2
Insurance contract or identification numberBXMA
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $290
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $19,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $290
Insurance broker nameLIGHTHOUSE INSURANCE GROUP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberAGP-3888
Policy instance 1
Insurance contract or identification numberAGP-3888
Number of Individuals Covered5
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,040
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,040
Insurance broker nameLIGHTHOUSE INSURANCE GROUP
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract numberBXMA
Policy instance 2
Insurance contract or identification numberBXMA
Number of Individuals Covered8
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $630
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $39,088
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $630
Insurance broker nameLIGHTHOUSE INSURANCE GROUP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberAGP-3888
Policy instance 1
Insurance contract or identification numberAGP-3888
Number of Individuals Covered8
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,843
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,764
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,843
Insurance broker nameLIGHTHOUSE INSURANCE GROUP
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract numberBXMA
Policy instance 3
Insurance contract or identification numberBXMA
Number of Individuals Covered12
Insurance policy start date2014-10-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $180
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $8,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $180
Amount paid for insurance broker fees0
Insurance broker nameLIGHTHOUSE INSURANCE GROUP
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number007022968-19/20
Policy instance 1
Insurance contract or identification number007022968-19/20
Number of Individuals Covered19
Insurance policy start date2014-01-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberAGP-3888
Policy instance 2
Insurance contract or identification numberAGP-3888
Number of Individuals Covered12
Insurance policy start date2014-10-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $514
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $514
Insurance broker nameLIGHTHOUSE INSURANCE GROUP
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number007022968-19/20
Policy instance 1
Insurance contract or identification number007022968-19/20
Number of Individuals Covered19
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,748
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 number007022968-19/20
Policy instance 1
Insurance contract or identification number007022968-19/20
Number of Individuals Covered22
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $157,459
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 number25961-900/901
Policy instance 1
Insurance contract or identification number25961-900/901
Number of Individuals Covered27
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $141,391
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 number25961-900/901
Policy instance 1
Insurance contract or identification number25961-900/901
Number of Individuals Covered29
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $154,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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