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DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 401k Plan overview

Plan NameDUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN
Plan identification number 501

DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 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

DUININCK COMPANIES has sponsored the creation of one or more 401k plans.

Company Name:DUININCK COMPANIES
Employer identification number (EIN):410721925
NAIC Classification:237310
NAIC Description:Highway, Street, and Bridge Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-01-01CONNIE STAHNKE CONNIE STAHNKE2019-07-18
5012017-01-01CONNIE STAHNKE CONNIE STAHNKE2018-10-08
5012016-01-01CONNIE STAHNKE CONNIE STAHNKE2017-10-12
5012015-01-01CONNIE STAHNKE CONNIE STAHNKE2016-10-13

Plan Statistics for DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN

401k plan membership statisitcs for DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN

Measure Date Value
2018: DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01622
Total number of active participants reported on line 7a of the Form 55002018-01-010
Total of all active and inactive participants2018-01-010
2017: DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01665
Total number of active participants reported on line 7a of the Form 55002017-01-01610
Number of retired or separated participants receiving benefits2017-01-016
Total of all active and inactive participants2017-01-01616
2016: DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01565
Total number of active participants reported on line 7a of the Form 55002016-01-01635
Number of retired or separated participants receiving benefits2016-01-014
Total of all active and inactive participants2016-01-01639
2015: DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01532
Total number of active participants reported on line 7a of the Form 55002015-01-01549
Number of retired or separated participants receiving benefits2015-01-012
Total of all active and inactive participants2015-01-01551

Financial Data on DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN

Measure Date Value
2018 : DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2018 401k financial data
Total transfer of assets from this plan2018-12-04$-562,259
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-04$593,441
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-04$1,102,143
Total income from all sources (including contributions)2018-12-04$6,460,020
Total of all expenses incurred2018-12-04$5,920,239
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-04$5,914,679
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-04$6,178,675
Value of total assets at end of year2018-12-04$593,441
Value of total assets at beginning of year2018-12-04$103
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-04$5,560
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-04Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2018-12-04$0
Was this plan covered by a fidelity bond2018-12-04Yes
Value of fidelity bond cover2018-12-04$50,000
If this is an individual account plan, was there a blackout period2018-12-04No
Were there any nonexempt tranactions with any party-in-interest2018-12-04No
Contributions received from participants2018-12-04$2,470,213
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-04$562,259
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-04$280,770
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-04$516,610
Other income not declared elsewhere2018-12-04$281,345
Total non interest bearing cash at end of year2018-12-04$31,182
Total non interest bearing cash at beginning of year2018-12-04$103
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-04No
Value of net income/loss2018-12-04$539,781
Value of net assets at end of year (total assets less liabilities)2018-12-04$0
Value of net assets at beginning of year (total assets less liabilities)2018-12-04$-1,102,040
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-04No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-04No
Were any leases to which the plan was party in default or uncollectible2018-12-04No
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-04$77,820
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-04No
Was there a failure to transmit to the plan any participant contributions2018-12-04No
Has the plan failed to provide any benefit when due under the plan2018-12-04No
Contributions received in cash from employer2018-12-04$3,708,462
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-04$5,836,859
Contract administrator fees2018-12-04$5,560
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-04No
Liabilities. Value of benefit claims payable at end of year2018-12-04$312,671
Liabilities. Value of benefit claims payable at beginning of year2018-12-04$585,533
Did the plan have assets held for investment2018-12-04No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-04No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-04Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-04No
Opinion of an independent qualified public accountant for this plan2018-12-04Unqualified
Accountancy firm name2018-12-04REDPATH AND COMPANY LTD
Accountancy firm EIN2018-12-04410975573
2017 : DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,102,143
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$904,887
Total income from all sources (including contributions)2017-12-31$6,227,998
Total of all expenses incurred2017-12-31$6,425,151
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$6,419,151
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$6,223,945
Value of total assets at end of year2017-12-31$103
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$6,000
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$50,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$2,613,971
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$516,610
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$516,282
Other income not declared elsewhere2017-12-31$4,053
Total non interest bearing cash at end of year2017-12-31$103
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-197,153
Value of net assets at end of year (total assets less liabilities)2017-12-31$-1,102,040
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-904,887
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$209,448
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$3,609,974
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$6,209,703
Contract administrator fees2017-12-31$6,000
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$585,533
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$388,605
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31REDPATHY AND COMPANY LTD
Accountancy firm EIN2017-12-31410975573
2016 : DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$904,887
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$805,594
Total income from all sources (including contributions)2016-12-31$6,641,426
Total of all expenses incurred2016-12-31$6,740,719
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$6,706,608
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$6,405,289
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$34,111
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$50,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,564,705
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$516,282
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$475,067
Other income not declared elsewhere2016-12-31$236,137
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-99,293
Value of net assets at end of year (total assets less liabilities)2016-12-31$-904,887
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-805,594
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$157,500
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$3,840,584
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$6,549,108
Contract administrator fees2016-12-31$34,111
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$388,605
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$330,527
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31REDPATH AND COMPANY LTD
Accountancy firm EIN2016-12-31410975573
2015 : DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$805,594
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$1,282,042
Total income from all sources (including contributions)2015-12-31$6,875,056
Total of all expenses incurred2015-12-31$6,398,608
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$6,351,295
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$6,295,396
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$47,313
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$50,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$2,007,096
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$475,067
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$332,322
Other income not declared elsewhere2015-12-31$579,660
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$476,448
Value of net assets at end of year (total assets less liabilities)2015-12-31$-805,594
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-1,282,042
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$87,860
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$4,288,300
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$6,263,435
Contract administrator fees2015-12-31$47,313
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$330,527
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$949,720
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31REDPATH AND COMPANY LTD
Accountancy firm EIN2015-12-31410975573

Form 5500 Responses for DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN

2018: DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01This submission is the final filingYes
2018-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: DUININCK COMPANIES COMPREHENSIVE HEALTH CARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )
Policy contract number26135
Policy instance 6
Insurance contract or identification number26135
Number of Individuals Covered1210
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $12,078
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $1,072,491
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees12078
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
Insurance broker organization code?3
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0002666
Policy instance 5
Insurance contract or identification numberW0002666
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $71
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9935511
Policy instance 4
Insurance contract or identification number9935511
Number of Individuals Covered816
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,076
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,076
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966524
Policy instance 3
Insurance contract or identification numberFLX966524
Number of Individuals Covered688
Insurance policy start date2018-01-01
Insurance policy end date2019-01-01
Total amount of commissions paid to insurance brokerUSD $17,077
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 providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $203,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,077
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number901406
Policy instance 2
Insurance contract or identification number901406
Number of Individuals Covered433
Insurance policy start date2018-01-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $17,102
Total amount of fees paid to insurance companyUSD $3,317
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $177,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,102
Amount paid for insurance broker fees3280
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0002666
Policy instance 1
Insurance contract or identification numberW0002666
Number of Individuals Covered158
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $125,002
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,032,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $73,380
Insurance broker organization code?3
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0002666
Policy instance 5
Insurance contract or identification numberW0002666
Number of Individuals Covered396
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $548
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $310
Insurance broker organization code?3
Insurance broker nameWORD AND BROWN
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9935511
Policy instance 4
Insurance contract or identification number9935511
Number of Individuals Covered743
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,574
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,574
Insurance broker organization code?3
Insurance broker nameRJF A MARSH AND MCLENNAN AGENCY LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966524
Policy instance 3
Insurance contract or identification numberFLX966524
Number of Individuals Covered962
Insurance policy start date2017-01-01
Insurance policy end date2018-01-01
Total amount of commissions paid to insurance brokerUSD $19,722
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 providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $247,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,722
Insurance broker organization code?3
Insurance broker nameMARSH AND MCLENNAN AGENCY LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5448852
Policy instance 2
Insurance contract or identification number5448852
Number of Individuals Covered410
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $30,208
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $301,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,208
Insurance broker organization code?3
Insurance broker nameRJF AGENCIES INC
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0002666
Policy instance 1
Insurance contract or identification numberW0002666
Number of Individuals Covered137
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $71,236
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $819,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,959
Insurance broker organization code?3
Insurance broker nameWORD AND BROWN
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9935511
Policy instance 4
Insurance contract or identification number9935511
Number of Individuals Covered527
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,982
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,982
Insurance broker organization code?3
Insurance broker nameRJF A MARSH AND MCLENNAN AGENCY LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966524
Policy instance 3
Insurance contract or identification numberFLX966524
Insurance policy start date2015-01-01
Insurance policy end date2016-01-01
Total amount of commissions paid to insurance brokerUSD $13,140
Total amount of fees paid to insurance companyUSD $4,037
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $111,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,140
Amount paid for insurance broker fees4037
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
Insurance broker organization code?3
Insurance broker nameMARSH AND MCLENNAN AGENCY LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5448852
Policy instance 2
Insurance contract or identification number5448852
Number of Individuals Covered239
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $20,034
Total amount of fees paid to insurance companyUSD $4,874
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $200,467
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,034
Insurance broker organization code?3
Amount paid for insurance broker fees4874
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
Insurance broker nameRJF AGENCIES INC
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number26135
Policy instance 1
Insurance contract or identification number26135
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $639,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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