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CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameCASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN
Plan identification number 501

CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

CASEY'S GENERAL STORES, INC has sponsored the creation of one or more 401k plans.

Company Name:CASEY'S GENERAL STORES, INC
Employer identification number (EIN):420935283
NAIC Classification:447100
NAIC Description: Gasoline Stations, Gas

Additional information about CASEY'S GENERAL STORES, INC

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 1967-12-13
Company Identification Number: 7285
Legal Registered Office Address: ONE SE CONVENIENCE BLVD

ANKENY
United States of America (USA)
50021

More information about CASEY'S GENERAL STORES, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01SHERRI HART2023-07-11
5012021-01-01SHERRI HART2022-07-20
5012020-01-01SHERRI HART2021-07-09
5012019-01-01SHERRI HART2020-07-14
5012018-01-01SHERRI HART2019-08-28
5012018-01-01SHERRI D. HART2019-11-12
5012017-01-01CINDI SUMMERS
5012016-01-01CINDI SUMMERS
5012015-01-01CINDI SUMMERS
5012014-01-01CINDI SUMMERS
5012013-01-01CINDI SUMMERS
5012012-01-01CINDI SUMMERS
5012011-01-01DOUGLAS DILLIVAN
5012010-01-01DOUGLAS DILLIVAN
5012009-01-01DOUGLAS DILLIVAN

Plan Statistics for CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0117,559
Total number of active participants reported on line 7a of the Form 55002022-01-0117,730
Number of retired or separated participants receiving benefits2022-01-0143
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0117,773
Number of employers contributing to the scheme2022-01-010
2021: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0116,737
Total number of active participants reported on line 7a of the Form 55002021-01-0117,026
Number of retired or separated participants receiving benefits2021-01-0164
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0117,090
Number of employers contributing to the scheme2021-01-010
2020: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0115,763
Total number of active participants reported on line 7a of the Form 55002020-01-0115,245
Number of retired or separated participants receiving benefits2020-01-0163
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0115,308
Number of employers contributing to the scheme2020-01-010
2019: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0115,044
Total number of active participants reported on line 7a of the Form 55002019-01-0115,438
Number of retired or separated participants receiving benefits2019-01-0163
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0115,501
Number of employers contributing to the scheme2019-01-010
2018: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0114,861
Total number of active participants reported on line 7a of the Form 55002018-01-0115,339
Number of retired or separated participants receiving benefits2018-01-0123
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0115,362
Number of employers contributing to the scheme2018-01-010
2017: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0114,036
Total number of active participants reported on line 7a of the Form 55002017-01-0115,015
Number of retired or separated participants receiving benefits2017-01-0124
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0115,039
2016: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0112,970
Total number of active participants reported on line 7a of the Form 55002016-01-0114,259
Number of retired or separated participants receiving benefits2016-01-0118
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0114,277
2015: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-016,103
Total number of active participants reported on line 7a of the Form 55002015-01-015,745
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 participants2015-01-015,745
2014: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0110,898
Total number of active participants reported on line 7a of the Form 55002014-01-0111,551
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0111,551
2013: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-019,009
Total number of active participants reported on line 7a of the Form 55002013-01-014,523
Number of retired or separated participants receiving benefits2013-01-0137
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-014,560
2012: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-014,185
Total number of active participants reported on line 7a of the Form 55002012-01-019,009
Number of retired or separated participants receiving benefits2012-01-0147
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-019,056
2011: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-013,825
Total number of active participants reported on line 7a of the Form 55002011-01-014,185
Total of all active and inactive participants2011-01-014,185
Total participants2011-01-014,185
2010: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-013,513
Total number of active participants reported on line 7a of the Form 55002010-01-013,825
Total of all active and inactive participants2010-01-013,825
Total participants2010-01-013,825
2009: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-012,856
Total number of active participants reported on line 7a of the Form 55002009-01-013,513
Total of all active and inactive participants2009-01-013,513
Total participants2009-01-013,513

Form 5500 Responses for CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN

2022: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: CASEY'S GENERAL STORES, INC. EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649222
Policy instance 4
Insurance contract or identification number649222
Number of Individuals Covered17694
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $361,935
Total amount of fees paid to insurance companyUSD $212,163
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $361,935
Amount paid for insurance broker fees30064
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number71199-3
Policy instance 3
Insurance contract or identification number71199-3
Number of Individuals Covered4151
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $311,589
Total amount of fees paid to insurance companyUSD $173,472
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $1,557,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $311,589
Amount paid for insurance broker fees33258
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number75000-1001
Policy instance 2
Insurance contract or identification number75000-1001
Number of Individuals Covered9360
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $109,813
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $686,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $68,633
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number32425
Policy instance 1
Insurance contract or identification number32425
Number of Individuals Covered6071
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $169,720
Total amount of fees paid to insurance companyUSD $5,843
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,423,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $169,720
Amount paid for insurance broker fees5843
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number75000-1001
Policy instance 2
Insurance contract or identification number75000-1001
Number of Individuals Covered9387
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $108,513
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $677,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $67,821
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number71199-3
Policy instance 3
Insurance contract or identification number71199-3
Number of Individuals Covered4188
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $328,446
Total amount of fees paid to insurance companyUSD $133,419
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $1,482,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $328,446
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSERVICE FEE
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649222
Policy instance 4
Insurance contract or identification number649222
Number of Individuals Covered21586
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $329,489
Total amount of fees paid to insurance companyUSD $225,310
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $329,489
Amount paid for insurance broker fees29868
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number32425
Policy instance 1
Insurance contract or identification number32425
Number of Individuals Covered6094
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $167,707
Total amount of fees paid to insurance companyUSD $5,854
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,396,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $167,707
Amount paid for insurance broker fees5854
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number75000-1001
Policy instance 2
Insurance contract or identification number75000-1001
Number of Individuals Covered9846
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $112,015
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $699,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70,007
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number71199-3
Policy instance 3
Insurance contract or identification number71199-3
Number of Individuals Covered4757
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $291,251
Total amount of fees paid to insurance companyUSD $162,212
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $1,456,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $291,251
Amount paid for insurance broker fees31150
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649222
Policy instance 4
Insurance contract or identification number649222
Number of Individuals Covered15060
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $401,582
Total amount of fees paid to insurance companyUSD $227,001
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $401,582
Amount paid for insurance broker fees31259
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number32425
Policy instance 1
Insurance contract or identification number32425
Number of Individuals Covered6274
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $171,306
Total amount of fees paid to insurance companyUSD $13,015
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,444,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $171,306
Amount paid for insurance broker fees6091
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649222
Policy instance 4
Insurance contract or identification number649222
Number of Individuals Covered15133
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $310,542
Total amount of fees paid to insurance companyUSD $195,761
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $125,671
Amount paid for insurance broker fees68739
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number920101
Policy instance 3
Insurance contract or identification number920101
Number of Individuals Covered3160
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $265,172
Total amount of fees paid to insurance companyUSD $11,753
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $1,325,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $174,952
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number32425
Policy instance 1
Insurance contract or identification number32425
Number of Individuals Covered6457
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $179,481
Total amount of fees paid to insurance companyUSD $11,389
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,373,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $108,685
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number75000-1001
Policy instance 2
Insurance contract or identification number75000-1001
Number of Individuals Covered9700
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $122,909
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $683,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,626
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number8001489
Policy instance 4
Insurance contract or identification number8001489
Number of Individuals Covered2419
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $185,934
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $853,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $185,934
Amount paid for insurance broker fees0
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649222
Policy instance 3
Insurance contract or identification number649222
Number of Individuals Covered15347
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $343,515
Total amount of fees paid to insurance companyUSD $198,624
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $343,515
Amount paid for insurance broker fees31997
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number75000-1001
Policy instance 2
Insurance contract or identification number75000-1001
Number of Individuals Covered9616
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $118,909
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $660,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $66,061
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number32425
Policy instance 1
Insurance contract or identification number32425
Number of Individuals Covered6264
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $153,895
Total amount of fees paid to insurance companyUSD $11,703
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,388,350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $153,895
Amount paid for insurance broker fees11703
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649222
Policy instance 2
Insurance contract or identification number649222
Number of Individuals Covered14754
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $222,039
Total amount of fees paid to insurance companyUSD $43,048
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 $117,200
Insurance broker organization code?3
Amount paid for insurance broker fees43048
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker nameBUSINESSSOLVER.COM INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649222
Policy instance 3
Insurance contract or identification number649222
Number of Individuals Covered578
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $45,496
Total amount of fees paid to insurance companyUSD $7,653
Long Term Disability 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 $26,695
Insurance broker organization code?3
Amount paid for insurance broker fees7653
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker nameBUSINESSOLVER.COM INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649222
Policy instance 4
Insurance contract or identification number649222
Number of Individuals Covered2499
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $135,331
Total amount of fees paid to insurance companyUSD $25,826
Temporary Disability 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 $73,228
Insurance broker organization code?3
Amount paid for insurance broker fees25826
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker nameBUSINESSOLVER.COM INC.
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number75000-1001
Policy instance 5
Insurance contract or identification number75000-1001
Number of Individuals Covered8980
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $110,001
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $611,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $56,234
Insurance broker organization code?5
Insurance broker nameTRUENORTH CO
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number8002203
Policy instance 6
Insurance contract or identification number8002203
Number of Individuals Covered1258
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $68,302
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $314,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,320
Insurance broker organization code?3
Insurance broker nameFRANK BERLIN & ASSOCIATES LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number8001489
Policy instance 7
Insurance contract or identification number8001489
Number of Individuals Covered1928
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $74,440
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $372,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,609
Insurance broker organization code?3
Insurance broker nameTRUENORTH COMPANIES LC
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number32425
Policy instance 1
Insurance contract or identification number32425
Number of Individuals Covered6035
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $164,100
Total amount of fees paid to insurance companyUSD $14,359
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,967,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $164,100
Amount paid for insurance broker fees14359
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
Insurance broker nameTRUENORTH

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