ARNOLD MOTOR SUPPLY, LLP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN
401k plan membership statisitcs for ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 478 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 520 |
| Total of all active and inactive participants | 2022-01-01 | 520 |
| Total participants | 2022-01-01 | 520 |
| 2021: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 353 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 375 |
| Total of all active and inactive participants | 2021-01-01 | 375 |
| Total participants | 2021-01-01 | 375 |
| 2020: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 369 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 353 |
| Total of all active and inactive participants | 2020-01-01 | 353 |
| Total participants | 2020-01-01 | 353 |
| 2019: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 357 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 369 |
| Total of all active and inactive participants | 2019-01-01 | 369 |
| Total participants | 2019-01-01 | 369 |
| Number of participants with account balances | 2019-01-01 | 0 |
| 2018: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 353 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 357 |
| Total of all active and inactive participants | 2018-01-01 | 357 |
| Total participants | 2018-01-01 | 357 |
| 2017: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 325 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 353 |
| Total of all active and inactive participants | 2017-01-01 | 353 |
| Total participants | 2017-01-01 | 353 |
| 2016: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-06-01 | 310 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 325 |
| Total of all active and inactive participants | 2016-06-01 | 325 |
| Total participants | 2016-06-01 | 325 |
| 2015: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 321 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 310 |
| Total of all active and inactive participants | 2015-06-01 | 310 |
| Total participants | 2015-06-01 | 0 |
| 2014: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-06-01 | 306 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 321 |
| Total of all active and inactive participants | 2014-06-01 | 321 |
| Total participants | 2014-06-01 | 0 |
| 2013: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-06-01 | 307 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 306 |
| Total of all active and inactive participants | 2013-06-01 | 306 |
| Total participants | 2013-06-01 | 0 |
| 2012: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-06-01 | 303 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 307 |
| Total of all active and inactive participants | 2012-06-01 | 307 |
| Total participants | 2012-06-01 | 0 |
| 2011: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-06-01 | 297 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 303 |
| Total of all active and inactive participants | 2011-06-01 | 303 |
| Total participants | 2011-06-01 | 303 |
| 2009: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-06-01 | 310 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 296 |
| Total of all active and inactive participants | 2009-06-01 | 296 |
| Total participants | 2009-06-01 | 296 |
| 2022: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Plan funding arrangement – Insurance | Yes |
| 2014-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | Plan funding arrangement – Insurance | Yes |
| 2013-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-06-01 | Type of plan entity | Single employer plan |
| 2012-06-01 | Plan funding arrangement – Insurance | Yes |
| 2012-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-06-01 | Type of plan entity | Single employer plan |
| 2011-06-01 | Plan funding arrangement – Insurance | Yes |
| 2011-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: ARNOLD MOTOR SUPPLY AND THE MERRILL COMPANY HEALTHCARE BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-06-01 | Type of plan entity | Single employer plan |
| 2009-06-01 | Plan funding arrangement – Insurance | Yes |
| 2009-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | AGP-030017 |
| Policy instance | 2 |
| Insurance contract or identification number | AGP-030017 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $248 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,300 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $248 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 000VY318 |
| Policy instance | 1 |
| Insurance contract or identification number | 000VY318 | | Number of Individuals Covered | 519 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $20,659 | | Total amount of fees paid to insurance company | USD $1,666 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $206,587 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,659 | | Amount paid for insurance broker fees | 1666 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | | Insurance broker organization code? | 3 |
|
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0207800000 |
| Policy instance | 3 |
| Insurance contract or identification number | 0207800000 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $595 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,270 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $198 | | Insurance broker organization code? | 3 |
|
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0207800000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0207800000 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,102 | | Other welfare benefits provided | CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $9,245 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $473 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000C5SL |
| Policy instance | 5 |
| Insurance contract or identification number | G000C5SL | | Number of Individuals Covered | 309 | | Insurance policy start date | 2022-09-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,150 | | Total amount of fees paid to insurance company | USD $575 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,500 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,150 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 575 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000C5SL |
| Policy instance | 6 |
| Insurance contract or identification number | G000C5SL | | Number of Individuals Covered | 183 | | Insurance policy start date | 2022-09-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $711 | | Total amount of fees paid to insurance company | USD $356 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,115 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $711 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 356 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000C5SL |
| Policy instance | 7 |
| Insurance contract or identification number | G000C5SL | | Number of Individuals Covered | 544 | | Insurance policy start date | 2022-09-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,080 | | Total amount of fees paid to insurance company | USD $540 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $10,796 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,080 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 540 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000C5SL |
| Policy instance | 8 |
| Insurance contract or identification number | G000C5SL | | Number of Individuals Covered | 154 | | Insurance policy start date | 2022-09-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,041 | | Total amount of fees paid to insurance company | USD $1,021 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,413 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,041 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1021 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000C5SL |
| Policy instance | 9 |
| Insurance contract or identification number | G000C5SL | | Number of Individuals Covered | 325 | | Insurance policy start date | 2022-09-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $4,707 | | Total amount of fees paid to insurance company | USD $2,942 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,835 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,707 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2942 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 147056 |
| Policy instance | 1 |
| Insurance contract or identification number | GL 147056 | | Number of Individuals Covered | 477 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,649 | | Total amount of fees paid to insurance company | USD $879 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $39,821 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,649 | | Amount paid for insurance broker fees | 879 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 261 |
| Policy instance | 1 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 375 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $37,468 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,468 | | Insurance broker organization code? | 3 |
|
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | 261 |
| Policy instance | 2 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 375 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0207800000 |
| Policy instance | 7 |
| Insurance contract or identification number | 0207800000 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $643 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,293 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $228 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 132326 |
| Policy instance | 2 |
| Insurance contract or identification number | LTD 132326 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,455 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,551 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,455 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 136-005149-0002 |
| Policy instance | 3 |
| Insurance contract or identification number | 136-005149-0002 | | Number of Individuals Covered | 598 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $759 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,674 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $496 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 136-005149-0001 |
| Policy instance | 4 |
| Insurance contract or identification number | 136-005149-0001 | | Number of Individuals Covered | 644 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,757 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $193,509 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,855 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPS 325491 |
| Policy instance | 5 |
| Insurance contract or identification number | VPS 325491 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,662 | | Total amount of fees paid to insurance company | USD $1,115 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,616 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,662 | | Amount paid for insurance broker fees | 1115 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | AGP-030017 |
| Policy instance | 6 |
| Insurance contract or identification number | AGP-030017 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $247 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,288 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $247 | | Insurance broker organization code? | 3 |
|
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0207800000 |
| Policy instance | 8 |
| Insurance contract or identification number | 0207800000 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,693 | | Other welfare benefits provided | CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $9,368 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $601 | | Insurance broker organization code? | 3 |
|
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | 261 |
| Policy instance | 2 |
| Insurance contract or identification number | 261 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 261 |
| Policy instance | 1 |
| Insurance contract or identification number | 261 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $36,898 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,898 | | Insurance broker organization code? | 3 |
|
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | 261 |
| Policy instance | 2 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 261 |
| Policy instance | 1 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $37,774 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,774 | | Insurance broker organization code? | 3 |
|
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | 261 |
| Policy instance | 2 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 357 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 261 |
| Policy instance | 1 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 357 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | 261 |
| Policy instance | 2 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 353 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 261 |
| Policy instance | 1 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 353 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 261 |
| Policy instance | 1 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 310 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 261 |
| Policy instance | 1 |
| Insurance contract or identification number | 261 | | Number of Individuals Covered | 321 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $-6 | | Total amount of fees paid to insurance company | USD $10,875 | | Health Insurance Welfare Benefit | Yes | | 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 | | Amount paid for insurance broker fees | 10875 | | Additional information about fees paid to insurance broker | INDIRECT COMMISSIONS ALLOCATION | | Insurance broker organization code? | 0 | | Insurance broker name | WELLMARK BLUE CROSS AND BLUE SHIELD |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 6002 |
| Policy instance | 4 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 306 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $8,849 | | Welfare Benefit Premiums Paid to Carrier | USD $88,479 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,849 | | Insurance broker organization code? | 4 | | Insurance broker name | COMMUNITY INSURANCE |
|
| MIDLANDS CHOICE, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 6002 |
| Policy instance | 3 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,362 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 6002 |
| Policy instance | 1 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 306 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $2,368 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $23,720 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,368 | | Insurance broker organization code? | 4 | | Insurance broker name | COMMUNITY INSURANCE |
|
| PREFERREDONE ADMINISTRATIVE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 6002 |
| Policy instance | 2 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Welfare Benefit Premiums Paid to Carrier | USD $381 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MIDLANDS CHOICE, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 6002 |
| Policy instance | 2 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Welfare Benefit Premiums Paid to Carrier | USD $3,390 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PREFERREDONE ADMINISTRATIVE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 6002 |
| Policy instance | 3 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Welfare Benefit Premiums Paid to Carrier | USD $913 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 6002 |
| Policy instance | 4 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 307 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $5,112 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $51,109 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,112 | | Insurance broker organization code? | 4 | | Insurance broker name | COMMUNITY INSURANCE |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 6002 |
| Policy instance | 1 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 307 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $19,788 | | Welfare Benefit Premiums Paid to Carrier | USD $197,991 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,788 | | Insurance broker organization code? | 4 | | Insurance broker name | COMMUNITY INSURANCE |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 6002 |
| Policy instance | 4 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 303 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $4,427 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $44,207 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 6002 |
| Policy instance | 1 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 303 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $17,771 | | Welfare Benefit Premiums Paid to Carrier | USD $177,602 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MIDLANDS CHOICE, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 6002 |
| Policy instance | 2 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Welfare Benefit Premiums Paid to Carrier | USD $3,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PREFERREDONE ADMINISTRATIVE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 6002 |
| Policy instance | 3 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Welfare Benefit Premiums Paid to Carrier | USD $969 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MIDLANDS CHOICE, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 6002 |
| Policy instance | 3 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Welfare Benefit Premiums Paid to Carrier | USD $3,125 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 6002 |
| Policy instance | 5 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 297 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $3,862 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $38,510 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TC3 (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 6002 |
| Policy instance | 1 |
| Insurance contract or identification number | 6002 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Other welfare benefits provided | % OF SAVINGS | | Welfare Benefit Premiums Paid to Carrier | USD $172 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PREFERREDONE ADMINISTRATIVE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 6002 |
| Policy instance | 4 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Welfare Benefit Premiums Paid to Carrier | USD $975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 6002 |
| Policy instance | 2 |
| Insurance contract or identification number | 6002 | | Number of Individuals Covered | 297 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $17,411 | | Welfare Benefit Premiums Paid to Carrier | USD $174,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
