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CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 401k Plan overview

Plan NameCURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN
Plan identification number 506

CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN Benefits

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

401k Sponsoring company profile

CURT G. JOA, INC. has sponsored the creation of one or more 401k plans.

Company Name:CURT G. JOA, INC.
Employer identification number (EIN):390376520
NAIC Classification:333200

Additional information about CURT G. JOA, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2014-08-13
Company Identification Number: 0802044886
Legal Registered Office Address: 100 CROCKER AVE

SHEBOYGAN FLS
United States of America (USA)
53085

More information about CURT G. JOA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062022-01-01SCOTT JENSEN2023-08-18
5062021-01-01SCOTT JENSEN2022-09-26
5062020-01-01SCOTT JENSEN2021-10-08
5062019-01-01
5062018-01-01
5062017-01-01SCOTT JENSEN
5062016-01-01SCOTT JENSEN

Plan Statistics for CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN

401k plan membership statisitcs for CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN

Measure Date Value
2022: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0183
Total number of active participants reported on line 7a of the Form 55002022-01-0198
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0112
Total of all active and inactive participants2022-01-01110
Number of employers contributing to the scheme2022-01-010
2021: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0183
Total number of active participants reported on line 7a of the Form 55002021-01-0198
Number of retired or separated participants receiving benefits2021-01-0198
Number of other retired or separated participants entitled to future benefits2021-01-0112
Total of all active and inactive participants2021-01-01208
Number of employers contributing to the scheme2021-01-010
2020: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0198
Total number of active participants reported on line 7a of the Form 55002020-01-0183
Number of retired or separated participants receiving benefits2020-01-0183
Number of other retired or separated participants entitled to future benefits2020-01-0110
Total of all active and inactive participants2020-01-01176
Number of employers contributing to the scheme2020-01-010
2019: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0183
Total number of active participants reported on line 7a of the Form 55002019-01-0189
Number of retired or separated participants receiving benefits2019-01-019
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0198
2018: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0176
Total number of active participants reported on line 7a of the Form 55002018-01-0179
Number of retired or separated participants receiving benefits2018-01-018
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0187
2017: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0199
Total number of active participants reported on line 7a of the Form 55002017-01-0197
Number of retired or separated participants receiving benefits2017-01-013
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01100
2016: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0174
Total number of active participants reported on line 7a of the Form 55002016-01-0171
Number of retired or separated participants receiving benefits2016-01-0181
Number of other retired or separated participants entitled to future benefits2016-01-0112
Total of all active and inactive participants2016-01-01164

Financial Data on CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN

Measure Date Value
2022 : CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-474,179
Expenses. Total of all expenses incurred2022-12-31$666,880
Benefits paid (including direct rollovers)2022-12-31$666,880
Total plan assets at end of year2022-12-31$4,215,477
Total plan assets at beginning of year2022-12-31$5,356,536
Value of fidelity bond covering the plan2022-12-31$1,000,000
Total contributions received or receivable from participants2022-12-31$64,705
Other income received2022-12-31$-538,884
Net income (gross income less expenses)2022-12-31$-1,141,059
Net plan assets at end of year (total assets less liabilities)2022-12-31$4,215,477
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$5,356,536
2021 : CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$970,273
Expenses. Total of all expenses incurred2021-12-31$655,571
Benefits paid (including direct rollovers)2021-12-31$655,571
Total plan assets at end of year2021-12-31$5,356,536
Total plan assets at beginning of year2021-12-31$5,041,834
Value of fidelity bond covering the plan2021-12-31$1,000,000
Total contributions received or receivable from participants2021-12-31$82,039
Other income received2021-12-31$888,234
Net income (gross income less expenses)2021-12-31$314,702
Net plan assets at end of year (total assets less liabilities)2021-12-31$5,356,536
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$5,041,834
Total contributions received or receivable from employer(s)2021-12-31$0
2020 : CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$73
Total income from all sources2020-12-31$1,818,729
Expenses. Total of all expenses incurred2020-12-31$593,510
Benefits paid (including direct rollovers)2020-12-31$593,510
Total plan assets at end of year2020-12-31$5,041,834
Total plan assets at beginning of year2020-12-31$3,816,688
Value of fidelity bond covering the plan2020-12-31$1,000,000
Total contributions received or receivable from participants2020-12-31$159,678
Other income received2020-12-31$309,051
Net income (gross income less expenses)2020-12-31$1,225,219
Net plan assets at end of year (total assets less liabilities)2020-12-31$5,041,834
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$3,816,615
Total contributions received or receivable from employer(s)2020-12-31$1,350,000
2019 : CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$73
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$372,283
Expenses. Total of all expenses incurred2019-12-31$365,435
Benefits paid (including direct rollovers)2019-12-31$359,610
Total plan assets at end of year2019-12-31$3,816,688
Total plan assets at beginning of year2019-12-31$3,809,767
Value of fidelity bond covering the plan2019-12-31$1,000,000
Total contributions received or receivable from participants2019-12-31$30,297
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$341,986
Other income received2019-12-31$0
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$6,848
Net plan assets at end of year (total assets less liabilities)2019-12-31$3,816,615
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$3,809,767
Total contributions received or receivable from employer(s)2019-12-31$0
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$5,825
2018 : CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$1,566,466
Expenses. Total of all expenses incurred2018-12-31$386,126
Benefits paid (including direct rollovers)2018-12-31$378,426
Total plan assets at end of year2018-12-31$3,809,767
Total plan assets at beginning of year2018-12-31$2,629,427
Value of fidelity bond covering the plan2018-12-31$1,000,000
Total contributions received or receivable from participants2018-12-31$79,028
Expenses. Other expenses not covered elsewhere2018-12-31$1,940
Other income received2018-12-31$237,438
Net income (gross income less expenses)2018-12-31$1,180,340
Net plan assets at end of year (total assets less liabilities)2018-12-31$3,809,767
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$2,629,427
Total contributions received or receivable from employer(s)2018-12-31$1,250,000
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$5,760
2017 : CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$1,508,313
Expenses. Total of all expenses incurred2017-12-31$360,273
Benefits paid (including direct rollovers)2017-12-31$353,473
Total plan assets at end of year2017-12-31$2,603,988
Total plan assets at beginning of year2017-12-31$1,455,948
Value of fidelity bond covering the plan2017-12-31$1,000,000
Total contributions received or receivable from participants2017-12-31$68,497
Expenses. Other expenses not covered elsewhere2017-12-31$1,915
Other income received2017-12-31$139,816
Net income (gross income less expenses)2017-12-31$1,148,040
Net plan assets at end of year (total assets less liabilities)2017-12-31$2,603,988
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,455,948
Total contributions received or receivable from employer(s)2017-12-31$1,300,000
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$4,885
2016 : CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$855,084
Expenses. Total of all expenses incurred2016-12-31$327,958
Benefits paid (including direct rollovers)2016-12-31$318,372
Total plan assets at end of year2016-12-31$1,455,948
Total plan assets at beginning of year2016-12-31$928,822
Value of fidelity bond covering the plan2016-12-31$1,000,000
Total contributions received or receivable from participants2016-12-31$53,184
Expenses. Other expenses not covered elsewhere2016-12-31$4,431
Other income received2016-12-31$51,900
Net income (gross income less expenses)2016-12-31$527,126
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,455,948
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$928,822
Total contributions received or receivable from employer(s)2016-12-31$750,000
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$5,155

Form 5500 Responses for CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN

2022: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CURT G. JOA, INC. RETIREE HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number303380
Policy instance 2
Insurance contract or identification number303380
Number of Individuals Covered5
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $500
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees500
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number303360
Policy instance 1
Insurance contract or identification number303360
Number of Individuals Covered175
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $18,200
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $422,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees18200
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number303360
Policy instance 1
Insurance contract or identification number303360
Number of Individuals Covered170
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $16,100
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $342,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees16100
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number303360
Policy instance 1
Insurance contract or identification number303360
Number of Individuals Covered159
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $18,100
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $421,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees16500
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number303360
Policy instance 1
Insurance contract or identification number303360
Number of Individuals Covered149
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $16,800
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $327,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,800
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number303380
Policy instance 2
Insurance contract or identification number303380
Number of Individuals Covered2
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $300
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $300
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number303380
Policy instance 4
Insurance contract or identification number303380
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number303360
Policy instance 3
Insurance contract or identification number303360
Number of Individuals Covered135
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $600
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $396,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees600
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number303143
Policy instance 2
Insurance contract or identification number303143
Number of Individuals Covered3
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $8,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number248094
Policy instance 1
Insurance contract or identification number248094
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $200
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number296253
Policy instance 6
Insurance contract or identification number296253
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $50
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees50
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number292033
Policy instance 5
Insurance contract or identification number292033
Number of Individuals Covered3
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $100
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $5,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees100
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number256658
Policy instance 4
Insurance contract or identification number256658
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $350
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees350
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 69671 )
Policy contract number254691
Policy instance 3
Insurance contract or identification number254691
Number of Individuals Covered24
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $850
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $65,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees850
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number254688
Policy instance 2
Insurance contract or identification number254688
Number of Individuals Covered104
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,400
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $277,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6400
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL BANK LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number251735
Policy instance 1
Insurance contract or identification number251735
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $5,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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