IMAGE TREND, INC. has sponsored the creation of one or more 401k plans.
Additional information about IMAGE TREND, INC.
Submission information for form 5500 for 401k plan IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT
401k plan membership statisitcs for IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT
| Measure | Date | Value |
|---|
| 2022: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 190 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 218 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 1 |
| Total of all active and inactive participants | 2022-01-01 | 219 |
| 2021: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 186 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 190 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 190 |
| 2020: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 176 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 186 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 186 |
| 2019: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 174 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 176 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 176 |
| 2018: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 169 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 174 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 174 |
| 2017: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 171 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 169 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 169 |
| 2016: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 165 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 171 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 171 |
| 2015: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 165 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 165 |
| 2014: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 133 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 155 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 159 |
| 2013: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 133 |
| Total of all active and inactive participants | 2013-01-01 | 133 |
| 2012: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 122 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 135 |
| Total of all active and inactive participants | 2012-01-01 | 135 |
| 2011: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 122 |
| Total of all active and inactive participants | 2011-01-01 | 122 |
| 2010: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 114 |
| Total of all active and inactive participants | 2010-01-01 | 114 |
| 2022: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: IMAGE TREND, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | First time form 5500 has been submitted | Yes |
| 2010-01-01 | Submission has been amended | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | MN05394237 |
| Policy instance | 4 |
| Insurance contract or identification number | MN05394237 | | Number of Individuals Covered | 813 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,455 | | Welfare Benefit Premiums Paid to Carrier | USD $16,784 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,455 |
|
| HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 ) |
| Policy contract number | 36697 |
| Policy instance | 3 |
| Insurance contract or identification number | 36697 | | Number of Individuals Covered | 428 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $76,438 | | Welfare Benefit Premiums Paid to Carrier | USD $1,765,311 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $76,438 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98956161001 |
| Policy instance | 2 |
| Insurance contract or identification number | 98956161001 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,065 | | Welfare Benefit Premiums Paid to Carrier | USD $9,906 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,065 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 226481 |
| Policy instance | 1 |
| Insurance contract or identification number | 226481 | | Number of Individuals Covered | 196 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 226481 |
| Policy instance | 1 |
| Insurance contract or identification number | 226481 | | Number of Individuals Covered | 196 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $16,599 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $110,657 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,599 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98956161001 |
| Policy instance | 2 |
| Insurance contract or identification number | 98956161001 | | Number of Individuals Covered | 199 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $928 | | Welfare Benefit Premiums Paid to Carrier | USD $8,659 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $928 | | Insurance broker organization code? | 3 |
|
| HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 ) |
| Policy contract number | 36697 |
| Policy instance | 3 |
| Insurance contract or identification number | 36697 | | Number of Individuals Covered | 380 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $61,472 | | Welfare Benefit Premiums Paid to Carrier | USD $1,698,785 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $61,472 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98956161001 |
| Policy instance | 3 |
| Insurance contract or identification number | 98956161001 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $692 | | Welfare Benefit Premiums Paid to Carrier | USD $6,975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $692 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 226481 |
| Policy instance | 2 |
| Insurance contract or identification number | 226481 | | Number of Individuals Covered | 211 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $14,561 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $104,838 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,561 | | Insurance broker organization code? | 3 |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PCH42128 |
| Policy instance | 1 |
| Insurance contract or identification number | PCH42128 | | Number of Individuals Covered | 362 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $81,149 | | Welfare Benefit Premiums Paid to Carrier | USD $1,347,996 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $54,099 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98956161001 |
| Policy instance | 3 |
| Insurance contract or identification number | 98956161001 | | Number of Individuals Covered | 137 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $585 | | Welfare Benefit Premiums Paid to Carrier | USD $5,738 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $585 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 226481 |
| Policy instance | 2 |
| Insurance contract or identification number | 226481 | | Number of Individuals Covered | 196 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $14,433 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $88,463 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,433 | | Insurance broker organization code? | 3 |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PCH42128 |
| Policy instance | 1 |
| Insurance contract or identification number | PCH42128 | | Number of Individuals Covered | 327 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $65,279 | | Welfare Benefit Premiums Paid to Carrier | USD $1,084,051 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,519 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98956161001 |
| Policy instance | 3 |
| Insurance contract or identification number | 98956161001 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $726 | | Welfare Benefit Premiums Paid to Carrier | USD $7,303 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $726 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 226481 |
| Policy instance | 2 |
| Insurance contract or identification number | 226481 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $13,246 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $88,277 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,246 | | Insurance broker organization code? | 3 |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PCH42128 |
| Policy instance | 1 |
| Insurance contract or identification number | PCH42128 | | Number of Individuals Covered | 325 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $60,067 | | Welfare Benefit Premiums Paid to Carrier | USD $997,513 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,045 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98956161001 |
| Policy instance | 3 |
| Insurance contract or identification number | 98956161001 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $584 | | Welfare Benefit Premiums Paid to Carrier | USD $6,957 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $584 | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 226481 |
| Policy instance | 2 |
| Insurance contract or identification number | 226481 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $11,890 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $79,267 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,890 | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PCH42128 |
| Policy instance | 1 |
| Insurance contract or identification number | PCH42128 | | Number of Individuals Covered | 322 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $53,125 | | Welfare Benefit Premiums Paid to Carrier | USD $885,420 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,417 | | Insurance broker organization code? | 3 | | Insurance broker name | ROGERS BENEFIT GROUP |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PCH42128 |
| Policy instance | 1 |
| Insurance contract or identification number | PCH42128 | | Number of Individuals Covered | 293 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $41,635 | | Welfare Benefit Premiums Paid to Carrier | USD $692,395 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,878 | | Insurance broker organization code? | 3 | | Insurance broker name | RJF A MARSH & MCLENNAN AGENCY LLC |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 226481 |
| Policy instance | 2 |
| Insurance contract or identification number | 226481 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $9,635 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $54,226 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,635 | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 226481 |
| Policy instance | 2 |
| Insurance contract or identification number | 226481 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $6,792 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,285 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PREFERREDONE COMMUNITY HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95724 ) |
| Policy contract number | PCH42128 |
| Policy instance | 1 |
| Insurance contract or identification number | PCH42128 | | Number of Individuals Covered | 275 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $36,231 | | Welfare Benefit Premiums Paid to Carrier | USD $605,497 | | 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 number | 226481 |
| Policy instance | 2 |
| Insurance contract or identification number | 226481 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $5,653 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,394 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,653 | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| PREFERREDONE COMMUNITY HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95724 ) |
| Policy contract number | PCH42128 |
| Policy instance | 1 |
| Insurance contract or identification number | PCH42128 | | Number of Individuals Covered | 220 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $34,802 | | Welfare Benefit Premiums Paid to Carrier | USD $576,881 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,574 | | Insurance broker organization code? | 3 | | Insurance broker name | RJF A MARSH & MCLENNAN AGENCY LLC |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5448115 |
| Policy instance | 2 |
| Insurance contract or identification number | 5448115 | | Number of Individuals Covered | 135 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $6,266 | | Total amount of fees paid to insurance company | USD $418 | | Welfare Benefit Premiums Paid to Carrier | USD $41,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,266 | | Amount paid for insurance broker fees | 418 | | Insurance broker organization code? | 3 | | Insurance broker name | RJF AGENCIES INC |
|
| PREFERREDONE COMMUNITY HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95724 ) |
| Policy contract number | PCH42128 |
| Policy instance | 1 |
| Insurance contract or identification number | PCH42128 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $37,931 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,841 | | Insurance broker organization code? | 3 | | Insurance broker name | RJF A MARSH & MCLENNAN AGENCY LLC |
|
