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WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameWILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN
Plan identification number 501

WILLIAM PENN UNIVERSITY HEALTH AND WELFARE 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
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

WILLIAM PENN UNIVERSITY has sponsored the creation of one or more 401k plans.

Company Name:WILLIAM PENN UNIVERSITY
Employer identification number (EIN):420707120
NAIC Classification:611000

Additional information about WILLIAM PENN UNIVERSITY

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 1893-07-10
Company Identification Number: 087586
Legal Registered Office Address: 201 TRUEBLOOD AVE

OSKALOOSA
United States of America (USA)
52577

More information about WILLIAM PENN UNIVERSITY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01BONNIE JOHNSON
5012016-01-01BONNIE JOHNSON
5012015-01-01BONNIE JOHNSON
5012014-01-01BONNIE JOHNSON
5012013-01-01BONNIE JOHNSON
5012012-01-01BONNIE JOHNSON
5012011-01-01BONNIE JOHNSON
5012009-01-01BONNIE JOHNSON

Plan Statistics for WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN

401k plan membership statisitcs for WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN

Measure Date Value
2022: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01146
Total number of active participants reported on line 7a of the Form 55002022-01-01141
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01141
2021: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01138
Total number of active participants reported on line 7a of the Form 55002021-01-01146
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01146
2020: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01145
Total number of active participants reported on line 7a of the Form 55002020-01-01138
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01138
2019: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01152
Total number of active participants reported on line 7a of the Form 55002019-01-01145
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01145
2018: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01168
Total number of active participants reported on line 7a of the Form 55002018-01-01152
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01152
2017: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01169
Total number of active participants reported on line 7a of the Form 55002017-01-01168
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01168
2016: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01365
Total number of active participants reported on line 7a of the Form 55002016-01-01366
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01366
2015: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01288
Total number of active participants reported on line 7a of the Form 55002015-01-01365
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01365
2014: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01800
Total number of active participants reported on line 7a of the Form 55002014-01-01288
Total of all active and inactive participants2014-01-01288
Total participants2014-01-010
2013: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01299
Total number of active participants reported on line 7a of the Form 55002013-01-01800
Total of all active and inactive participants2013-01-01800
Total participants2013-01-010
2012: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01180
Total number of active participants reported on line 7a of the Form 55002012-01-01299
Total of all active and inactive participants2012-01-01299
Total participants2012-01-010
2011: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01150
Total number of active participants reported on line 7a of the Form 55002011-01-01180
Total of all active and inactive participants2011-01-01180
Total participants2011-01-01180
2009: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01157
Total number of active participants reported on line 7a of the Form 55002009-01-01149
Total of all active and inactive participants2009-01-01149
Total participants2009-01-01149

Form 5500 Responses for WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN

2022: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: WILLIAM PENN UNIVERSITY HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number00075653
Policy instance 7
Insurance contract or identification number00075653
Number of Individuals Covered73
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $484,557
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 number00075653
Policy instance 1
Insurance contract or identification number00075653
Number of Individuals Covered41
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,088,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number35292
Policy instance 2
Insurance contract or identification number35292
Number of Individuals Covered141
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,634
Total amount of fees paid to insurance companyUSD $496
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,271
Amount paid for insurance broker fees410
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0BQFM
Policy instance 3
Insurance contract or identification numberGLTD0BQFM
Number of Individuals Covered141
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,614
Total amount of fees paid to insurance companyUSD $2,113
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,614
Amount paid for insurance broker fees1242
Additional information about fees paid to insurance brokerOTHER COMPENSATION AGENT/BROKER
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BQFM
Policy instance 4
Insurance contract or identification numberGLUG0BQFM
Number of Individuals Covered141
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,748
Total amount of fees paid to insurance companyUSD $1,415
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $11,655
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,748
Amount paid for insurance broker fees832
Additional information about fees paid to insurance brokerOTHER COMPENSATION AGENT/BROKER
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG0BQFM
Policy instance 5
Insurance contract or identification numberGUG0BQFM
Number of Individuals Covered141
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,974
Total amount of fees paid to insurance companyUSD $2,407
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,974
Amount paid for insurance broker fees1416
Additional information about fees paid to insurance brokerOTHER COMPENSATION AGENT/BROKER
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVLTD0BQFM
Policy instance 6
Insurance contract or identification numberGVLTD0BQFM
Number of Individuals Covered68
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,845
Total amount of fees paid to insurance companyUSD $2,450
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $18,968
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,845
Amount paid for insurance broker fees1502
Additional information about fees paid to insurance brokerOTHER COMPENSATION AGENT/BROKER
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BQFM
Policy instance 4
Insurance contract or identification numberGLUG0BQFM
Number of Individuals Covered138
Insurance policy start date2020-07-01
Insurance policy end date2021-07-01
Total amount of commissions paid to insurance brokerUSD $1,640
Total amount of fees paid to insurance companyUSD $547
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $10,931
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,640
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Amount paid for insurance broker fees547
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number00075653
Policy instance 1
Insurance contract or identification number00075653
Number of Individuals Covered113
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,532,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG0BQFM
Policy instance 5
Insurance contract or identification numberGUG0BQFM
Number of Individuals Covered138
Insurance policy start date2020-07-01
Insurance policy end date2021-07-01
Total amount of commissions paid to insurance brokerUSD $2,785
Total amount of fees paid to insurance companyUSD $928
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,785
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Amount paid for insurance broker fees928
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0BQFM
Policy instance 3
Insurance contract or identification numberGLTD0BQFM
Number of Individuals Covered138
Insurance policy start date2020-07-01
Insurance policy end date2021-07-01
Total amount of commissions paid to insurance brokerUSD $2,443
Total amount of fees paid to insurance companyUSD $814
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,443
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Amount paid for insurance broker fees814
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVLTD0BQFM
Policy instance 6
Insurance contract or identification numberGVLTD0BQFM
Number of Individuals Covered66
Insurance policy start date2020-07-01
Insurance policy end date2021-07-01
Total amount of commissions paid to insurance brokerUSD $3,010
Total amount of fees paid to insurance companyUSD $1,003
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $20,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,010
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Amount paid for insurance broker fees1003
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number35292
Policy instance 2
Insurance contract or identification number35292
Number of Individuals Covered146
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,668
Total amount of fees paid to insurance companyUSD $248
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,730
Amount paid for insurance broker fees206
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33145
Policy instance 2
Insurance contract or identification number33145
Number of Individuals Covered124
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $4,306
Total amount of fees paid to insurance companyUSD $437
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,295
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,306
Amount paid for insurance broker fees437
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number335731
Policy instance 5
Insurance contract or identification number335731
Number of Individuals Covered3173
Insurance policy start date2020-01-01
Insurance policy end date2020-07-01
Total amount of commissions paid to insurance brokerUSD $22,112
Total amount of fees paid to insurance companyUSD $1,974
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $232,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,028
Amount paid for insurance broker fees1627
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number631595
Policy instance 3
Insurance contract or identification number631595
Number of Individuals Covered138
Insurance policy start date2020-01-01
Insurance policy end date2020-07-01
Total amount of commissions paid to insurance brokerUSD $217
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (ADD)
Welfare Benefit Premiums Paid to CarrierUSD $17,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $217
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number631596
Policy instance 4
Insurance contract or identification number631596
Number of Individuals Covered23
Insurance policy start date2020-01-01
Insurance policy end date2020-07-01
Total amount of commissions paid to insurance brokerUSD $83
Life Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (LIFESTYLE ADD)
Welfare Benefit Premiums Paid to CarrierUSD $6,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $83
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number0000800710007
Policy instance 1
Insurance contract or identification number0000800710007
Number of Individuals Covered105
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Health Insurance Welfare BenefitYes
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 number0000800710007
Policy instance 1
Insurance contract or identification number0000800710007
Number of Individuals Covered112
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number335731
Policy instance 4
Insurance contract or identification number335731
Number of Individuals Covered143
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33145
Policy instance 2
Insurance contract or identification number33145
Number of Individuals Covered127
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,398
Total amount of fees paid to insurance companyUSD $481
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,398
Amount paid for insurance broker fees481
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number631595
Policy instance 3
Insurance contract or identification number631595
Number of Individuals Covered145
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Total amount of commissions paid to insurance brokerUSD $230
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (ADD)
Welfare Benefit Premiums Paid to CarrierUSD $18,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $230
Insurance broker organization code?3
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number0000800710007
Policy instance 1
Insurance contract or identification number0000800710007
Number of Individuals Covered116
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $24,888
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,888
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33145
Policy instance 2
Insurance contract or identification number33145
Number of Individuals Covered134
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,843
Total amount of fees paid to insurance companyUSD $599
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,843
Amount paid for insurance broker fees599
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS (IC)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number335731
Policy instance 4
Insurance contract or identification number335731
Number of Individuals Covered155
Insurance policy start date2017-01-01
Insurance policy end date2018-01-01
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameMERCER HELATH & BENEFITS - URB
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number631595
Policy instance 5
Insurance contract or identification number631595
Number of Individuals Covered168
Insurance policy start date2017-01-01
Insurance policy end date2018-01-01
Total amount of commissions paid to insurance brokerUSD $354
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (ADD)
Welfare Benefit Premiums Paid to CarrierUSD $28,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $354
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS - URB
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number631596-0001
Policy instance 3
Insurance contract or identification number631596-0001
Number of Individuals Covered45
Insurance policy start date2017-01-01
Insurance policy end date2018-01-01
Total amount of commissions paid to insurance brokerUSD $176
Life Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (SPECIFY)ADD
Welfare Benefit Premiums Paid to CarrierUSD $14,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $176
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS - URB
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number631596-0001
Policy instance 5
Insurance contract or identification number631596-0001
Number of Individuals Covered42
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (SPECIFY)ADD
Welfare Benefit Premiums Paid to CarrierUSD $4,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS - URB
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number335731-0122
Policy instance 4
Insurance contract or identification number335731-0122
Number of Individuals Covered163
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of fees paid to insurance companyUSD $110
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees110
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS - URB
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number687
Policy instance 3
Insurance contract or identification number687
Number of Individuals Covered365
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $23,293
Total amount of fees paid to insurance companyUSD $535
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $423,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,293
Amount paid for insurance broker fees535
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS (IC)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number631595
Policy instance 2
Insurance contract or identification number631595
Number of Individuals Covered158
Insurance policy start date2015-07-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (SPECIFY)ACCIDENTAL DEATH & D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameMERCER HEALTH & BENEFITS -URB
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number0000800710007
Policy instance 1
Insurance contract or identification number0000800710007
Number of Individuals Covered122
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $24,486
Health Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (SPECIFY)DRUG
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,486
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number000800710007
Policy instance 1
Insurance contract or identification number000800710007
Number of Individuals Covered288
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedDRUG
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 )
Policy contract numberGL-0706
Policy instance 2
Insurance contract or identification numberGL-0706
Number of Individuals Covered168
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,076
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,076
Insurance broker organization code?3
Insurance broker nameKIRBY P MOSS
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number687
Policy instance 3
Insurance contract or identification number687
Number of Individuals Covered138
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,854
Total amount of fees paid to insurance companyUSD $570
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,854
Amount paid for insurance broker fees570
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 4
Insurance contract or identification number53282
Number of Individuals Covered166
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,707
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,707
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORS INC.DBA ACUMEN
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 5
Insurance contract or identification number53282
Number of Individuals Covered166
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,407
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,407
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORS INC.DBA ACUMEN
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number000800710007
Policy instance 1
Insurance contract or identification number000800710007
Number of Individuals Covered298
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedDRUG
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 5
Insurance contract or identification number53282
Number of Individuals Covered174
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,647
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,647
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORS INCD DBA ACUMEN
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number687
Policy instance 3
Insurance contract or identification number687
Number of Individuals Covered151
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,910
Total amount of fees paid to insurance companyUSD $562
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,910
Amount paid for insurance broker fees562
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 4
Insurance contract or identification number53282
Number of Individuals Covered174
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,652
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,652
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORS INCD DBA ACUMEN
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 )
Policy contract numberGL-0706
Policy instance 2
Insurance contract or identification numberGL-0706
Number of Individuals Covered177
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,346
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,346
Insurance broker organization code?3
Insurance broker nameKIRBY P MOSS
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 2
Insurance contract or identification number53282
Number of Individuals Covered179
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,028
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,028
Insurance broker organization code?3
Insurance broker nameBENEFIT SOLUTIONS INC
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number000800710007
Policy instance 5
Insurance contract or identification number000800710007
Number of Individuals Covered144
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedDRUG
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 )
Policy contract numberGL-0706
Policy instance 4
Insurance contract or identification numberGL-0706
Number of Individuals Covered180
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,901
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,901
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORS INC.
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number687
Policy instance 3
Insurance contract or identification number687
Number of Individuals Covered155
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,943
Total amount of fees paid to insurance companyUSD $481
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,943
Amount paid for insurance broker fees481
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 1
Insurance contract or identification number53282
Number of Individuals Covered179
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,729
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,729
Insurance broker organization code?3
Insurance broker nameBENEFIT SOLUTIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 1
Insurance contract or identification number53282
Number of Individuals Covered179
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,453
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,775
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 number000800710007
Policy instance 5
Insurance contract or identification number000800710007
Number of Individuals Covered148
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedDRUG
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 )
Policy contract numberGL-0706
Policy instance 4
Insurance contract or identification numberGL-0706
Number of Individuals Covered180
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,559
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number687
Policy instance 3
Insurance contract or identification number687
Number of Individuals Covered156
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,727
Total amount of fees paid to insurance companyUSD $591
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,942
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 2
Insurance contract or identification number53282
Number of Individuals Covered179
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,849
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 1
Insurance contract or identification number53282
Number of Individuals Covered182
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,652
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,652
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFIT SOLUTIONS INC
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number000800710007
Policy instance 5
Insurance contract or identification number000800710007
Number of Individuals Covered150
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 )
Policy contract numberGL-0706
Policy instance 4
Insurance contract or identification numberGL-0706
Number of Individuals Covered182
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,430
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,430
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
Insurance broker organization code?3
Insurance broker nameBENEFIT SOLUTIONS INC
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number687
Policy instance 3
Insurance contract or identification number687
Number of Individuals Covered157
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,284
Total amount of fees paid to insurance companyUSD $521
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $77,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,284
Amount paid for insurance broker fees521
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53282
Policy instance 2
Insurance contract or identification number53282
Number of Individuals Covered182
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,586
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,586
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFIT SOLUTIONS INC

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