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WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 401k Plan overview

Plan NameWRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC.
Plan identification number 503

WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

BURLINGTON GRAPHICS SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name:BURLINGTON GRAPHICS SYSTEMS, INC.
Employer identification number (EIN):391394844
NAIC Classification:541400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01JEFF KNUSTSON2023-07-21
5032021-05-01JEFF KNUTSON2022-05-02
5032020-05-01JEFF KNUTSON2021-11-30 JEFF KNUTSON2021-11-30
5032019-05-01JEFF KNUTSON2020-11-11 JEFF KNUTSON2020-11-11
5032018-05-01JEFF KNUTSON2020-01-29 JEFF KNUTSON2020-01-29
5032017-05-01
5032016-05-01
5032015-05-01
5032014-05-01
5032013-05-01
5032012-05-01MARK EDWARDS MARK EDWARDS2013-12-02

Plan Statistics for WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC.

401k plan membership statisitcs for WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC.

Measure Date Value
2022: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2022 401k membership
Total participants, beginning-of-year2022-01-01204
Total number of active participants reported on line 7a of the Form 55002022-01-01262
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01262
Number of employers contributing to the scheme2022-01-010
2021: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2021 401k membership
Total participants, beginning-of-year2021-05-01143
Total number of active participants reported on line 7a of the Form 55002021-05-01204
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01204
Number of employers contributing to the scheme2021-05-010
2020: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2020 401k membership
Total participants, beginning-of-year2020-05-01172
Total number of active participants reported on line 7a of the Form 55002020-05-01143
Number of retired or separated participants receiving benefits2020-05-010
Total of all active and inactive participants2020-05-01143
2019: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2019 401k membership
Total participants, beginning-of-year2019-05-01172
Total number of active participants reported on line 7a of the Form 55002019-05-01171
Number of retired or separated participants receiving benefits2019-05-011
Total of all active and inactive participants2019-05-01172
2018: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2018 401k membership
Total participants, beginning-of-year2018-05-01195
Total number of active participants reported on line 7a of the Form 55002018-05-01171
Number of retired or separated participants receiving benefits2018-05-011
Total of all active and inactive participants2018-05-01172
2017: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2017 401k membership
Total participants, beginning-of-year2017-05-01173
Total number of active participants reported on line 7a of the Form 55002017-05-01195
Number of retired or separated participants receiving benefits2017-05-013
Total of all active and inactive participants2017-05-01198
2016: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2016 401k membership
Total participants, beginning-of-year2016-05-01147
Total number of active participants reported on line 7a of the Form 55002016-05-01172
Number of retired or separated participants receiving benefits2016-05-011
Total of all active and inactive participants2016-05-01173
2015: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2015 401k membership
Total participants, beginning-of-year2015-05-01166
Total number of active participants reported on line 7a of the Form 55002015-05-01152
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-01152
2014: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2014 401k membership
Total participants, beginning-of-year2014-05-01156
Total number of active participants reported on line 7a of the Form 55002014-05-01166
Total of all active and inactive participants2014-05-01166
2013: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2013 401k membership
Total participants, beginning-of-year2013-05-01125
Total number of active participants reported on line 7a of the Form 55002013-05-01156
Total of all active and inactive participants2013-05-01156
2012: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2012 401k membership
Total participants, beginning-of-year2012-05-01110
Total number of active participants reported on line 7a of the Form 55002012-05-01125
Total of all active and inactive participants2012-05-01125

Form 5500 Responses for WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC.

2022: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – General assets of the sponsorYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – General assets of the sponsorYes
2019: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – General assets of the sponsorYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – General assets of the sponsorYes
2018: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – General assets of the sponsorYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – General assets of the sponsorYes
2017: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – General assets of the sponsorYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – General assets of the sponsorYes
2016: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – General assets of the sponsorYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – General assets of the sponsorYes
2015: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: WRAP WELFARE BENEFITS PLAN OF BURLINGTON GRAPHIC SYSTEMS, INC. 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01First time form 5500 has been submittedYes
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5969998
Policy instance 4
Insurance contract or identification number5969998
Number of Individuals Covered444
Insurance policy start date2022-01-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $1,029
Total amount of fees paid to insurance companyUSD $1,555
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,029
Amount paid for insurance broker fees1555
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
AURORA HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 3
Insurance contract or identification number00
Number of Individuals Covered262
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 $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $4,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number906517
Policy instance 2
Insurance contract or identification number906517
Number of Individuals Covered202
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,838
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $22,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,838
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number8522
Policy instance 1
Insurance contract or identification number8522
Number of Individuals Covered146
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,049
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,049
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5969998
Policy instance 1
Insurance contract or identification number5969998
Number of Individuals Covered432
Insurance policy start date2021-05-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,417
Total amount of fees paid to insurance companyUSD $73
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $68,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,417
Amount paid for insurance broker fees73
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number906517
Policy instance 2
Insurance contract or identification number906517
Number of Individuals Covered202
Insurance policy start date2021-05-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,290
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $16,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,290
Amount paid for insurance broker fees0
Insurance broker organization code?3
AURORA HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 3
Insurance contract or identification number00
Number of Individuals Covered204
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 $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $3,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5969998
Policy instance 2
Insurance contract or identification number5969998
Number of Individuals Covered407
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $3,895
Total amount of fees paid to insurance companyUSD $2,396
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,895
Amount paid for insurance broker fees2396
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number906517
Policy instance 1
Insurance contract or identification number906517
Number of Individuals Covered392
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $4,865
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,865
Insurance broker organization code?3
WPS HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 10159 )
Policy contract number10012016
Policy instance 2
Insurance contract or identification number10012016
Number of Individuals Covered280
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $35,298
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,298
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number906517
Policy instance 1
Insurance contract or identification number906517
Number of Individuals Covered171
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $115,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number906517
Policy instance 1
Insurance contract or identification number906517
Number of Individuals Covered392
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $10,247
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,632
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,247
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number00172843
Policy instance 2
Insurance contract or identification number00172843
Number of Individuals Covered76
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $7,515
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $424,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,515
Insurance broker organization code?3
COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 )
Policy contract number00172843
Policy instance 3
Insurance contract or identification number00172843
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $105
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $5,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $105
Insurance broker organization code?3
COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 )
Policy contract number00172843
Policy instance 3
Insurance contract or identification number00172843
Number of Individuals Covered117
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $27,166
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $767,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,166
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES, LLC
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number00172843
Policy instance 2
Insurance contract or identification number00172843
Number of Individuals Covered38
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $10,376
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $293,290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,376
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES, LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5480409
Policy instance 1
Insurance contract or identification number5480409
Number of Individuals Covered195
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $5,804
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $107,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,804
Insurance broker organization code?3
Insurance broker nameJOHNSON INS SERVICES LLC
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number001007358
Policy instance 1
Insurance contract or identification number001007358
Number of Individuals Covered152
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $1,353
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,353
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES, LLC
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number00172843
Policy instance 2
Insurance contract or identification number00172843
Number of Individuals Covered152
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $10,061
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $234,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,061
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES, LLC
COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 )
Policy contract number00172843
Policy instance 3
Insurance contract or identification number00172843
Number of Individuals Covered152
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $22,717
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $570,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,717
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES, LLC
COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 )
Policy contract number00172843
Policy instance 3
Insurance contract or identification number00172843
Number of Individuals Covered166
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $13,893
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $495,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,893
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES, LLC
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number00172843
Policy instance 2
Insurance contract or identification number00172843
Number of Individuals Covered166
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $7,661
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $216,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,661
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES, LLC
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00172843
Policy instance 1
Insurance contract or identification number00172843
Number of Individuals Covered166
Insurance policy start date2015-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $712
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $712
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES, LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number612263
Policy instance 1
Insurance contract or identification number612263
Number of Individuals Covered156
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $40,826
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $718,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,826
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number612263
Policy instance 1
Insurance contract or identification number612263
Number of Individuals Covered125
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $30,904
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $549,581
Commission paid to Insurance BrokerUSD $30,904
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES LLC

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