BRECK SCHOOL has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BRECK SCHOOL MEDICAL AND DENTAL PLAN
Measure | Date | Value |
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2022: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-07-01 | 248 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 224 |
Number of retired or separated participants receiving benefits | 2022-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
Total of all active and inactive participants | 2022-07-01 | 224 |
Number of employers contributing to the scheme | 2022-07-01 | 0 |
2021: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-07-01 | 260 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 248 |
Number of retired or separated participants receiving benefits | 2021-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
Total of all active and inactive participants | 2021-07-01 | 248 |
Number of employers contributing to the scheme | 2021-07-01 | 0 |
2020: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-07-01 | 271 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 260 |
Number of retired or separated participants receiving benefits | 2020-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-07-01 | 0 |
Total of all active and inactive participants | 2020-07-01 | 260 |
Number of employers contributing to the scheme | 2020-07-01 | 0 |
2019: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-07-01 | 272 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 271 |
Number of retired or separated participants receiving benefits | 2019-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-07-01 | 0 |
Total of all active and inactive participants | 2019-07-01 | 271 |
Number of employers contributing to the scheme | 2019-07-01 | 0 |
2018: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-07-01 | 272 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 272 |
Number of retired or separated participants receiving benefits | 2018-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
Total of all active and inactive participants | 2018-07-01 | 272 |
Number of employers contributing to the scheme | 2018-07-01 | 0 |
2017: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-07-01 | 290 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 272 |
Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
Total of all active and inactive participants | 2017-07-01 | 272 |
Number of employers contributing to the scheme | 2017-07-01 | 0 |
2016: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-07-01 | 293 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 290 |
Number of retired or separated participants receiving benefits | 2016-07-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
Total of all active and inactive participants | 2016-07-01 | 293 |
2015: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-07-01 | 258 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 293 |
Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 0 |
Total of all active and inactive participants | 2015-07-01 | 293 |
2014: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-07-01 | 258 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 221 |
Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
Total of all active and inactive participants | 2014-07-01 | 221 |
2013: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-07-01 | 239 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 255 |
Number of retired or separated participants receiving benefits | 2013-07-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 0 |
Total of all active and inactive participants | 2013-07-01 | 258 |
2012: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-07-01 | 219 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 220 |
Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 0 |
Total of all active and inactive participants | 2012-07-01 | 220 |
2011: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-07-01 | 214 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 215 |
Number of retired or separated participants receiving benefits | 2011-07-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2011-07-01 | 0 |
Total of all active and inactive participants | 2011-07-01 | 219 |
2010: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-07-01 | 211 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 211 |
Number of retired or separated participants receiving benefits | 2010-07-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2010-07-01 | 0 |
Total of all active and inactive participants | 2010-07-01 | 215 |
2009: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-07-01 | 228 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 220 |
Number of retired or separated participants receiving benefits | 2009-07-01 | 7 |
Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 0 |
Total of all active and inactive participants | 2009-07-01 | 227 |
2022: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2022 form 5500 responses |
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2022-07-01 | Type of plan entity | Single employer plan |
2022-07-01 | Plan is a collectively bargained plan | Yes |
2022-07-01 | Plan funding arrangement – Insurance | Yes |
2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-07-01 | Plan benefit arrangement – Insurance | Yes |
2022-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2021 form 5500 responses |
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2021-07-01 | Type of plan entity | Single employer plan |
2021-07-01 | Plan is a collectively bargained plan | Yes |
2021-07-01 | Plan funding arrangement – Insurance | Yes |
2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-07-01 | Plan benefit arrangement – Insurance | Yes |
2021-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2020 form 5500 responses |
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2020-07-01 | Type of plan entity | Single employer plan |
2020-07-01 | Plan is a collectively bargained plan | Yes |
2020-07-01 | Plan funding arrangement – Insurance | Yes |
2020-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-07-01 | Plan benefit arrangement – Insurance | Yes |
2020-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2019 form 5500 responses |
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2019-07-01 | Type of plan entity | Single employer plan |
2019-07-01 | Plan is a collectively bargained plan | Yes |
2019-07-01 | Plan funding arrangement – Insurance | Yes |
2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-07-01 | Plan benefit arrangement – Insurance | Yes |
2019-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2018 form 5500 responses |
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2018-07-01 | Type of plan entity | Single employer plan |
2018-07-01 | Plan is a collectively bargained plan | Yes |
2018-07-01 | Plan funding arrangement – Insurance | Yes |
2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-07-01 | Plan benefit arrangement – Insurance | Yes |
2018-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2017 form 5500 responses |
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2017-07-01 | Type of plan entity | Single employer plan |
2017-07-01 | Plan is a collectively bargained plan | Yes |
2017-07-01 | Plan funding arrangement – Insurance | Yes |
2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-07-01 | Plan benefit arrangement – Insurance | Yes |
2017-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2016 form 5500 responses |
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2016-07-01 | Type of plan entity | Single employer plan |
2016-07-01 | Submission has been amended | No |
2016-07-01 | This submission is the final filing | No |
2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-07-01 | Plan is a collectively bargained plan | Yes |
2016-07-01 | Plan funding arrangement – Insurance | Yes |
2016-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-07-01 | Plan benefit arrangement – Insurance | Yes |
2016-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2015 form 5500 responses |
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2015-07-01 | Type of plan entity | Single employer plan |
2015-07-01 | Submission has been amended | No |
2015-07-01 | This submission is the final filing | No |
2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-07-01 | Plan is a collectively bargained plan | Yes |
2015-07-01 | Plan funding arrangement – Insurance | Yes |
2015-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-07-01 | Plan benefit arrangement – Insurance | Yes |
2015-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2014 form 5500 responses |
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2014-07-01 | Type of plan entity | Single employer plan |
2014-07-01 | Submission has been amended | No |
2014-07-01 | This submission is the final filing | No |
2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-07-01 | Plan is a collectively bargained plan | Yes |
2014-07-01 | Plan funding arrangement – Insurance | Yes |
2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-07-01 | Plan benefit arrangement – Insurance | Yes |
2014-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2013 form 5500 responses |
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2013-07-01 | Type of plan entity | Single employer plan |
2013-07-01 | Submission has been amended | No |
2013-07-01 | This submission is the final filing | No |
2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-07-01 | Plan is a collectively bargained plan | Yes |
2013-07-01 | Plan funding arrangement – Insurance | Yes |
2013-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-07-01 | Plan benefit arrangement – Insurance | Yes |
2013-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2012 form 5500 responses |
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2012-07-01 | Type of plan entity | Multi-employer plan |
2012-07-01 | Submission has been amended | No |
2012-07-01 | This submission is the final filing | No |
2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-07-01 | Plan is a collectively bargained plan | Yes |
2012-07-01 | Plan funding arrangement – Insurance | Yes |
2012-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-07-01 | Plan benefit arrangement – Insurance | Yes |
2012-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2011 form 5500 responses |
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2011-07-01 | Type of plan entity | Multi-employer plan |
2011-07-01 | Submission has been amended | No |
2011-07-01 | This submission is the final filing | No |
2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-07-01 | Plan is a collectively bargained plan | Yes |
2011-07-01 | Plan funding arrangement – Insurance | Yes |
2011-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-07-01 | Plan benefit arrangement – Insurance | Yes |
2011-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2010: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2010 form 5500 responses |
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2010-07-01 | Type of plan entity | Multi-employer plan |
2010-07-01 | Submission has been amended | No |
2010-07-01 | This submission is the final filing | No |
2010-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-07-01 | Plan is a collectively bargained plan | Yes |
2010-07-01 | Plan funding arrangement – Insurance | Yes |
2010-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2010-07-01 | Plan benefit arrangement – Insurance | Yes |
2010-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: BRECK SCHOOL MEDICAL AND DENTAL PLAN 2009 form 5500 responses |
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2009-07-01 | Type of plan entity | Multi-employer plan |
2009-07-01 | Submission has been amended | No |
2009-07-01 | This submission is the final filing | No |
2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-07-01 | Plan is a collectively bargained plan | Yes |
2009-07-01 | Plan funding arrangement – Insurance | Yes |
2009-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-07-01 | Plan benefit arrangement – Insurance | Yes |
2009-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3393 |
Policy instance | 1 |
Insurance contract or identification number | 3393 | Number of Individuals Covered | 255 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Total amount of commissions paid to insurance broker | USD $52,000 | Total amount of fees paid to insurance company | USD $133 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $3,935,290 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52,000 | Amount paid for insurance broker fees | 133 | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | Insurance broker organization code? | 3 |
|
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3393 |
Policy instance | 1 |
Insurance contract or identification number | 3393 | Number of Individuals Covered | 486 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $44,000 | Total amount of fees paid to insurance company | USD $131 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $3,385,333 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,000 | Amount paid for insurance broker fees | 131 | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | Insurance broker organization code? | 3 |
|
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3393 |
Policy instance | 1 |
Insurance contract or identification number | 3393 | Number of Individuals Covered | 473 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $47,943 | Total amount of fees paid to insurance company | USD $128 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $3,544,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $47,943 | Amount paid for insurance broker fees | 128 | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | Insurance broker organization code? | 3 |
|
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3393 |
Policy instance | 1 |
Insurance contract or identification number | 3393 | Number of Individuals Covered | 496 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $48,000 | Total amount of fees paid to insurance company | USD $134 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $3,828,108 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,000 | Amount paid for insurance broker fees | 134 | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | Insurance broker organization code? | 3 |
|
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3393 |
Policy instance | 1 |
Insurance contract or identification number | 3393 | Number of Individuals Covered | 498 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $48,052 | Total amount of fees paid to insurance company | USD $4,534 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $3,344,128 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $48,052 | Amount paid for insurance broker fees | 4534 | Additional information about fees paid to insurance broker | BONUS INDIRECT COMPENSATION | Insurance broker organization code? | 3 |
|
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3393 |
Policy instance | 1 |
Insurance contract or identification number | 3393 | Number of Individuals Covered | 514 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $2 | Total amount of fees paid to insurance company | USD $47,737 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $3,178,535 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2 | Amount paid for insurance broker fees | 47737 | Additional information about fees paid to insurance broker | BROKER SERVICE FEE/INDIRECT COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
|
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3393 |
Policy instance | 1 |
Insurance contract or identification number | 3393 | Number of Individuals Covered | 493 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $45,340 | Are there contracts with allocated funds for individual policies? | No | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | 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 Carrier | USD $2,779,442 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 45340 | Additional information about fees paid to insurance broker | BONUS BROKER SERVICE FEE | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE |
|
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3393 |
Policy instance | 1 |
Insurance contract or identification number | 3393 | Number of Individuals Covered | 478 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $48,268 | Total amount of fees paid to insurance company | USD $10 | Are there contracts with allocated funds for individual policies? | No | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | 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 Carrier | USD $2,990,346 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $48,268 | Amount paid for insurance broker fees | 10 | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
|
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3393 |
Policy instance | 1 |
Insurance contract or identification number | 3393 | Number of Individuals Covered | 473 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $38,661 | Total amount of fees paid to insurance company | USD $10 | Are there contracts with allocated funds for individual policies? | No | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | 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 Carrier | USD $2,844,836 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $38,661 | Amount paid for insurance broker fees | 10 | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
Policy contract number | GP413 |
Policy instance | 1 |
Insurance contract or identification number | GP413 | Number of Individuals Covered | 481 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $33,800 | Total amount of fees paid to insurance company | USD $102 | Are there contracts with allocated funds for individual policies? | No | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $2,622,569 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $33,800 | Amount paid for insurance broker fees | 102 | Additional information about fees paid to insurance broker | BROKER INCENTIVE | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
Policy contract number | GP413 |
Policy instance | 1 |
Insurance contract or identification number | GP413 | Number of Individuals Covered | 456 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $36,568 | Total amount of fees paid to insurance company | USD $1,288 | Are there contracts with allocated funds for individual policies? | No | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $2,607,238 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
Policy contract number | GP413 |
Policy instance | 1 |
Insurance contract or identification number | GP413 | Number of Individuals Covered | 420 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $37,583 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $2,796,885 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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