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SATURN OF ST. PAUL WELFARE BENEFIT PLAN 401k Plan overview

Plan NameSATURN OF ST. PAUL WELFARE BENEFIT PLAN
Plan identification number 501

SATURN OF ST. PAUL WELFARE BENEFIT PLAN Benefits

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

SATURN OF ST. PAUL has sponsored the creation of one or more 401k plans.

Company Name:SATURN OF ST. PAUL
Employer identification number (EIN):411676172
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SATURN OF ST. PAUL WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-10-01VALERIE KENNEDY2023-07-14
5012020-10-01VALERIE KENNEDY2022-06-29
5012019-10-01VALERIE KENNEDY2021-06-30
5012018-10-01VALERIE KENNEDY2020-04-28
5012017-10-01
5012016-10-01
5012015-10-01VALERIE KENNEDY
5012014-10-01VALERIE KENNEDY
5012013-10-01VALERIE KENNEDY
5012012-10-01VALERIE KENNEDY
5012011-10-01JACQUELINE PRZYBYLSKI
5012010-10-01JACQUELINE PRZYBYLSKI
5012009-10-01TOM WEED
5012008-10-01

Plan Statistics for SATURN OF ST. PAUL WELFARE BENEFIT PLAN

401k plan membership statisitcs for SATURN OF ST. PAUL WELFARE BENEFIT PLAN

Measure Date Value
2021: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01153
Total number of active participants reported on line 7a of the Form 55002021-10-01165
Number of retired or separated participants receiving benefits2021-10-010
Total of all active and inactive participants2021-10-01165
2020: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01152
Total number of active participants reported on line 7a of the Form 55002020-10-01136
Number of retired or separated participants receiving benefits2020-10-012
Total of all active and inactive participants2020-10-01138
2019: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01182
Total number of active participants reported on line 7a of the Form 55002019-10-01151
Number of retired or separated participants receiving benefits2019-10-010
Total of all active and inactive participants2019-10-01151
2018: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01184
Total number of active participants reported on line 7a of the Form 55002018-10-01189
Number of retired or separated participants receiving benefits2018-10-011
Total of all active and inactive participants2018-10-01190
2017: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01155
Total number of active participants reported on line 7a of the Form 55002017-10-01166
Number of retired or separated participants receiving benefits2017-10-011
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01167
2016: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01150
Total number of active participants reported on line 7a of the Form 55002016-10-01152
Number of retired or separated participants receiving benefits2016-10-013
Total of all active and inactive participants2016-10-01155
2015: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01153
Total number of active participants reported on line 7a of the Form 55002015-10-01159
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01159
2014: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01142
Total number of active participants reported on line 7a of the Form 55002014-10-01145
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01145
2013: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01124
Total number of active participants reported on line 7a of the Form 55002013-10-01135
Number of retired or separated participants receiving benefits2013-10-011
Total of all active and inactive participants2013-10-01136
2012: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01119
Total number of active participants reported on line 7a of the Form 55002012-10-01123
Total of all active and inactive participants2012-10-01123
2011: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01122
Total number of active participants reported on line 7a of the Form 55002011-10-01122
Number of retired or separated participants receiving benefits2011-10-011
Total of all active and inactive participants2011-10-01123
2010: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-01129
Total number of active participants reported on line 7a of the Form 55002010-10-01134
Number of retired or separated participants receiving benefits2010-10-014
Total of all active and inactive participants2010-10-01138
2009: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01143
Total number of active participants reported on line 7a of the Form 55002009-10-01132
Number of retired or separated participants receiving benefits2009-10-013
Total of all active and inactive participants2009-10-01135

Form 5500 Responses for SATURN OF ST. PAUL WELFARE BENEFIT PLAN

2021: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2011: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – General assets of the sponsorYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – General assets of the sponsorYes
2010: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan funding arrangement – General assets of the sponsorYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-10-01Plan benefit arrangement – General assets of the sponsorYes
2009: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01This submission is the final filingNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – General assets of the sponsorYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – General assets of the sponsorYes
2008: SATURN OF ST. PAUL WELFARE BENEFIT PLAN 2008 form 5500 responses
2008-10-01Type of plan entitySingle employer plan
2008-10-01Submission has been amendedNo
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)No
2008-10-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number309272
Policy instance 2
Insurance contract or identification number309272
Number of Individuals Covered118
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $44,307
Total amount of fees paid to insurance companyUSD $495
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $738,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,496
Amount paid for insurance broker fees495
Additional information about fees paid to insurance brokerBROKER INCENTIVE PROGRAM
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number232723
Policy instance 1
Insurance contract or identification number232723
Number of Individuals Covered145
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $7,655
Total amount of fees paid to insurance companyUSD $2,144
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
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 $61,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,655
Amount paid for insurance broker fees2144
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number309272
Policy instance 2
Insurance contract or identification number309272
Number of Individuals Covered114
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $46,725
Total amount of fees paid to insurance companyUSD $602
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $778,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,725
Amount paid for insurance broker fees602
Additional information about fees paid to insurance brokerBROKER INCENTIVE PROGRAM
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number232723
Policy instance 1
Insurance contract or identification number232723
Number of Individuals Covered160
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $7,296
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 $57,677
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,296
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number232723
Policy instance 1
Insurance contract or identification number232723
Number of Individuals Covered150
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $7,181
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 $59,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,181
Insurance broker organization code?3
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number309272
Policy instance 2
Insurance contract or identification number309272
Number of Individuals Covered122
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $40,640
Total amount of fees paid to insurance companyUSD $1,628
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $677,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,640
Amount paid for insurance broker fees1628
Additional information about fees paid to insurance brokerBROKER INCENTIVE PROGRAM
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberMKA25,28,29,&32
Policy instance 3
Insurance contract or identification numberMKA25,28,29,&32
Number of Individuals Covered65
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $17,641
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedHOSPITAL, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $37,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,351
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number21186
Policy instance 3
Insurance contract or identification number21186
Number of Individuals Covered60
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $835
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedHOSPITAL, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $9,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $237
Insurance broker organization code?3
PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 )
Policy contract numberPCH10576
Policy instance 1
Insurance contract or identification numberPCH10576
Number of Individuals Covered124
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $38,795
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $649,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,795
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number232723
Policy instance 2
Insurance contract or identification number232723
Number of Individuals Covered194
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $6,197
Total amount of fees paid to insurance companyUSD $1,017
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 $53,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,197
Amount paid for insurance broker fees1017
Additional information about fees paid to insurance brokerPRODUCTION BONUS
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number21186
Policy instance 3
Insurance contract or identification number21186
Number of Individuals Covered60
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $1,277
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedHOSPITAL, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $9,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number232723
Policy instance 2
Insurance contract or identification number232723
Number of Individuals Covered167
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $5,749
Total amount of fees paid to insurance companyUSD $832
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 $46,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 )
Policy contract numberPCH10576
Policy instance 1
Insurance contract or identification numberPCH10576
Number of Individuals Covered107
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $31,679
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $522,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number232723
Policy instance 2
Insurance contract or identification number232723
Number of Individuals Covered145
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $4,809
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 $36,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,809
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 )
Policy contract numberPCH10576
Policy instance 1
Insurance contract or identification numberPCH10576
Number of Individuals Covered99
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $24,288
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $404,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,288
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number232723
Policy instance 2
Insurance contract or identification number232723
Number of Individuals Covered145
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $4,877
Total amount of fees paid to insurance companyUSD $765
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 $34,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,877
Amount paid for insurance broker fees765
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 )
Policy contract numberPCH10576
Policy instance 1
Insurance contract or identification numberPCH10576
Number of Individuals Covered96
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $19,829
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $330,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,829
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 )
Policy contract number20752
Policy instance 1
Insurance contract or identification number20752
Number of Individuals Covered88
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $17,271
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $286,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,271
Insurance broker organization code?3
Insurance broker nameCLYDE STOCKEY
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number851481G
Policy instance 2
Insurance contract or identification number851481G
Number of Individuals Covered120
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $293
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $293
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number232723
Policy instance 3
Insurance contract or identification number232723
Number of Individuals Covered133
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $3,728
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,728
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number851481G
Policy instance 2
Insurance contract or identification number851481G
Number of Individuals Covered120
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $4,469
Total amount of fees paid to insurance companyUSD $361
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,469
Amount paid for insurance broker fees361
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameASSOCIATED FINANCIAL GROUP LLC
HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 )
Policy contract number20752
Policy instance 1
Insurance contract or identification number20752
Number of Individuals Covered73
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $15,664
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $261,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,664
Insurance broker organization code?3
Insurance broker nameCLYDE STOCKEY
HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 )
Policy contract number20752
Policy instance 1
Insurance contract or identification number20752
Number of Individuals Covered70
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $17,450
Total amount of fees paid to insurance companyUSD $2,244
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $301,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number851481G
Policy instance 2
Insurance contract or identification number851481G
Number of Individuals Covered122
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $4,748
Total amount of fees paid to insurance companyUSD $365
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number20752
Policy instance 1
Insurance contract or identification number20752
Number of Individuals Covered94
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $7,480
Total amount of fees paid to insurance companyUSD $538
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number851481G
Policy instance 2
Insurance contract or identification number851481G
Number of Individuals Covered128
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $5,412
Total amount of fees paid to insurance companyUSD $470
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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