DATA DIMENSIONS, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN
401k plan membership statisitcs for DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN
| Measure | Date | Value |
|---|
| 2023: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 548 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 537 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 22 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 559 |
| 2022: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 419 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 542 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 6 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 548 |
| 2021: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 354 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 415 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 419 |
| 2020: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 737 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 346 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 15 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 361 |
| 2019: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 831 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 730 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 7 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 737 |
| 2018: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 914 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 823 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 828 |
| 2017: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 768 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 893 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 38 |
| Total of all active and inactive participants | 2017-01-01 | 931 |
| 2016: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 746 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 743 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 3 |
| Total of all active and inactive participants | 2016-01-01 | 746 |
| 2015: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 945 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 701 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 4 |
| Total of all active and inactive participants | 2015-01-01 | 705 |
| 2014: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 567 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 896 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 5 |
| Total of all active and inactive participants | 2014-01-01 | 901 |
| 2013: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 215 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 469 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 4 |
| Total of all active and inactive participants | 2013-01-01 | 473 |
| 2012: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 152 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 188 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 3 |
| Total of all active and inactive participants | 2012-01-01 | 193 |
| 2011: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 172 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 151 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 154 |
| 2010: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 136 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 166 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 6 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 172 |
| 2009: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 133 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 136 |
| 2023: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: DATA DIMENSIONS CORPORATION HOSPITALIZATION WELFARE PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | L00106 |
| Policy instance | 5 |
| Insurance contract or identification number | L00106 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $86,358 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | L00106 |
| Policy instance | 4 |
| Insurance contract or identification number | L00106 | | Number of Individuals Covered | 261 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,738,067 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 2496 |
| Policy instance | 3 |
| Insurance contract or identification number | 2496 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | HSA | | Welfare Benefit Premiums Paid to Carrier | USD $237,432 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 42 |
| Policy instance | 2 |
| Insurance contract or identification number | 42 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,403,839 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00539107 |
| Policy instance | 1 |
| Insurance contract or identification number | 00539107 | | Number of Individuals Covered | 537 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $31,751 | | Total amount of fees paid to insurance company | USD $9,645 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT, AD&D, VOLUNTARY CI | | Welfare Benefit Premiums Paid to Carrier | USD $262,362 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00539107 |
| Policy instance | 1 |
| Insurance contract or identification number | 00539107 | | Number of Individuals Covered | 542 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $60,956 | | Total amount of fees paid to insurance company | USD $4,735 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT, AD&D, VOLUNTARY CI | | Welfare Benefit Premiums Paid to Carrier | USD $6,395 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 42 |
| Policy instance | 2 |
| Insurance contract or identification number | 42 | | Number of Individuals Covered | 208 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,152,147 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 2496 |
| Policy instance | 3 |
| Insurance contract or identification number | 2496 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | HSA | | Welfare Benefit Premiums Paid to Carrier | USD $192,131 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | L00106 |
| Policy instance | 4 |
| Insurance contract or identification number | L00106 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,227,903 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | L00106 |
| Policy instance | 5 |
| Insurance contract or identification number | L00106 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $81,473 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00539107 |
| Policy instance | 1 |
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 42 |
| Policy instance | 2 |
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 2496 |
| Policy instance | 3 |
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | L00106 |
| Policy instance | 4 |
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | L00106 |
| Policy instance | 5 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00539107 |
| Policy instance | 1 |
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 180780 |
| Policy instance | 2 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0905135 |
| Policy instance | 3 |
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | L00106 |
| Policy instance | 4 |
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 ) |
| Policy contract number | G0423 |
| Policy instance | 5 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417006410685 |
| Policy instance | 6 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 417008410685 |
| Policy instance | 7 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00539107 |
| Policy instance | 1 |
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 180780 |
| Policy instance | 2 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0905135 |
| Policy instance | 3 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0905135 |
| Policy instance | 3 |
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 180780 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 000PL394 |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151301 |
| Policy instance | 6 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 417004410685 |
| Policy instance | 5 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417006410685 |
| Policy instance | 4 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0905135 |
| Policy instance | 3 |
| MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
| Policy contract number | 180780 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 54682 ) |
| Policy contract number | 12032957 |
| Policy instance | 1 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 54682 ) |
| Policy contract number | 12032957 |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151301 |
| Policy instance | 2 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 417005410685 |
| Policy instance | 3 |
| DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 ) |
| Policy contract number | 12PG5QH |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151301 |
| Policy instance | 3 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417005410685 |
| Policy instance | 4 |
| DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 ) |
| Policy contract number | 12PG5QH |
| Policy instance | 1 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 54682 ) |
| Policy contract number | 12032957 |
| Policy instance | 2 |
| DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 ) |
| Policy contract number | 12PG5QH |
| Policy instance | 1 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 54682 ) |
| Policy contract number | 12032957 |
| Policy instance | 3 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417005410685 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 933536 |
| Policy instance | 2 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417005410685 |
| Policy instance | 4 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 96108 |
| Policy instance | 3 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 933536 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 54682 ) |
| Policy contract number | 12032957 |
| Policy instance | 1 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 96108 |
| Policy instance | 1 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 417004410685 |
| Policy instance | 2 |
| UNITED MEDICAL RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 76410685 |
| Policy instance | 3 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417005410685 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 933536 |
| Policy instance | 5 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 54682 ) |
| Policy contract number | 12032957 |
| Policy instance | 6 |
| QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) |
| Policy contract number | D487 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 54682 ) |
| Policy contract number | 12032957 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00436934 |
| Policy instance | 1 |
