HY-LINE LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST
401k plan membership statisitcs for HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST
| Measure | Date | Value |
|---|
| 2017: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 59 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 55 |
| Total of all active and inactive participants | 2017-07-01 | 55 |
| Total participants | 2017-07-01 | 55 |
| 2016: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 55 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 59 |
| Total of all active and inactive participants | 2016-07-01 | 59 |
| Total participants | 2016-07-01 | 59 |
| 2015: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 55 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 55 |
| Total of all active and inactive participants | 2015-07-01 | 55 |
| Total participants | 2015-07-01 | 55 |
| 2014: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 59 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 55 |
| Total of all active and inactive participants | 2014-07-01 | 55 |
| Total participants | 2014-07-01 | 55 |
| 2013: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 61 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 59 |
| Total of all active and inactive participants | 2013-07-01 | 59 |
| Total participants | 2013-07-01 | 59 |
| 2012: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 65 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 61 |
| Total of all active and inactive participants | 2012-07-01 | 61 |
| Total participants | 2012-07-01 | 61 |
| 2011: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 64 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 65 |
| Total of all active and inactive participants | 2011-07-01 | 65 |
| Total participants | 2011-07-01 | 65 |
| 2009: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 67 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 65 |
| Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 0 |
| Total of all active and inactive participants | 2009-07-01 | 65 |
| Measure | Date | Value |
|---|
| 2018 : HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2018 401k financial data |
|---|
| Total income from all sources | 2018-06-30 | $1,412,369 |
| Expenses. Total of all expenses incurred | 2018-06-30 | $515,838 |
| Benefits paid (including direct rollovers) | 2018-06-30 | $513,338 |
| Total plan assets at end of year | 2018-06-30 | $7,758,726 |
| Total plan assets at beginning of year | 2018-06-30 | $6,862,195 |
| Value of fidelity bond covering the plan | 2018-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2018-06-30 | $54,336 |
| Expenses. Other expenses not covered elsewhere | 2018-06-30 | $2,500 |
| Other income received | 2018-06-30 | $374,198 |
| Net income (gross income less expenses) | 2018-06-30 | $896,531 |
| Net plan assets at end of year (total assets less liabilities) | 2018-06-30 | $7,758,726 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-06-30 | $6,862,195 |
| Total contributions received or receivable from employer(s) | 2018-06-30 | $983,835 |
| 2017 : HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2017 401k financial data |
|---|
| Total income from all sources | 2017-06-30 | $1,500,340 |
| Expenses. Total of all expenses incurred | 2017-06-30 | $597,762 |
| Benefits paid (including direct rollovers) | 2017-06-30 | $595,262 |
| Total plan assets at end of year | 2017-06-30 | $6,846,195 |
| Total plan assets at beginning of year | 2017-06-30 | $5,943,617 |
| Value of fidelity bond covering the plan | 2017-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2017-06-30 | $49,270 |
| Expenses. Other expenses not covered elsewhere | 2017-06-30 | $2,500 |
| Other income received | 2017-06-30 | $371,243 |
| Net income (gross income less expenses) | 2017-06-30 | $902,578 |
| Net plan assets at end of year (total assets less liabilities) | 2017-06-30 | $6,846,195 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-06-30 | $5,943,617 |
| Total contributions received or receivable from employer(s) | 2017-06-30 | $1,079,827 |
| 2016 : HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2016 401k financial data |
|---|
| Total income from all sources | 2016-06-30 | $971,162 |
| Expenses. Total of all expenses incurred | 2016-06-30 | $522,907 |
| Benefits paid (including direct rollovers) | 2016-06-30 | $520,407 |
| Total plan assets at end of year | 2016-06-30 | $5,943,617 |
| Total plan assets at beginning of year | 2016-06-30 | $5,495,362 |
| Value of fidelity bond covering the plan | 2016-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2016-06-30 | $45,600 |
| Expenses. Other expenses not covered elsewhere | 2016-06-30 | $2,500 |
| Other income received | 2016-06-30 | $15,540 |
| Net income (gross income less expenses) | 2016-06-30 | $448,255 |
| Net plan assets at end of year (total assets less liabilities) | 2016-06-30 | $5,943,617 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-06-30 | $5,495,362 |
| Total contributions received or receivable from employer(s) | 2016-06-30 | $910,022 |
| 2015 : HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2015 401k financial data |
|---|
| Total income from all sources | 2015-06-30 | $940,906 |
| Expenses. Total of all expenses incurred | 2015-06-30 | $408,919 |
| Benefits paid (including direct rollovers) | 2015-06-30 | $406,312 |
| Total plan assets at end of year | 2015-06-30 | $5,495,362 |
| Total plan assets at beginning of year | 2015-06-30 | $4,963,375 |
| Value of fidelity bond covering the plan | 2015-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2015-06-30 | $44,019 |
| Expenses. Other expenses not covered elsewhere | 2015-06-30 | $2,607 |
| Other income received | 2015-06-30 | $100,272 |
| Net income (gross income less expenses) | 2015-06-30 | $531,987 |
| Net plan assets at end of year (total assets less liabilities) | 2015-06-30 | $5,495,362 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-06-30 | $4,963,375 |
| Total contributions received or receivable from employer(s) | 2015-06-30 | $796,615 |
| 2014 : HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2014 401k financial data |
|---|
| Total income from all sources | 2014-06-30 | $1,151,354 |
| Expenses. Total of all expenses incurred | 2014-06-30 | $379,149 |
| Benefits paid (including direct rollovers) | 2014-06-30 | $376,369 |
| Total plan assets at end of year | 2014-06-30 | $4,963,375 |
| Total plan assets at beginning of year | 2014-06-30 | $4,191,170 |
| Value of fidelity bond covering the plan | 2014-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2014-06-30 | $41,104 |
| Expenses. Other expenses not covered elsewhere | 2014-06-30 | $2,780 |
| Other income received | 2014-06-30 | $748,043 |
| Net income (gross income less expenses) | 2014-06-30 | $772,205 |
| Net plan assets at end of year (total assets less liabilities) | 2014-06-30 | $4,963,375 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-06-30 | $4,191,170 |
| Total contributions received or receivable from employer(s) | 2014-06-30 | $362,207 |
| 2013 : HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2013 401k financial data |
|---|
| Total income from all sources | 2013-06-30 | $1,009,395 |
| Expenses. Total of all expenses incurred | 2013-06-30 | $395,193 |
| Benefits paid (including direct rollovers) | 2013-06-30 | $387,493 |
| Total plan assets at end of year | 2013-06-30 | $4,191,170 |
| Total plan assets at beginning of year | 2013-06-30 | $3,576,968 |
| Value of fidelity bond covering the plan | 2013-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2013-06-30 | $41,682 |
| Expenses. Other expenses not covered elsewhere | 2013-06-30 | $7,700 |
| Other income received | 2013-06-30 | $210,280 |
| Net income (gross income less expenses) | 2013-06-30 | $614,202 |
| Net plan assets at end of year (total assets less liabilities) | 2013-06-30 | $4,191,170 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-06-30 | $3,576,968 |
| Total contributions received or receivable from employer(s) | 2013-06-30 | $757,433 |
| 2012 : HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2012 401k financial data |
|---|
| Total plan liabilities at end of year | 2012-06-30 | $0 |
| Total plan liabilities at beginning of year | 2012-06-30 | $0 |
| Total income from all sources | 2012-06-30 | $845,708 |
| Expenses. Total of all expenses incurred | 2012-06-30 | $440,206 |
| Benefits paid (including direct rollovers) | 2012-06-30 | $437,706 |
| Total plan assets at end of year | 2012-06-30 | $3,576,968 |
| Total plan assets at beginning of year | 2012-06-30 | $3,576,084 |
| Value of fidelity bond covering the plan | 2012-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2012-06-30 | $45,708 |
| Expenses. Other expenses not covered elsewhere | 2012-06-30 | $2,500 |
| Net income (gross income less expenses) | 2012-06-30 | $405,502 |
| Net plan assets at end of year (total assets less liabilities) | 2012-06-30 | $3,576,968 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-06-30 | $3,576,084 |
| Total contributions received or receivable from employer(s) | 2012-06-30 | $800,000 |
| 2011 : HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2011 401k financial data |
|---|
| Total plan liabilities at end of year | 2011-06-30 | $0 |
| Total plan liabilities at beginning of year | 2011-06-30 | $9,584 |
| Total income from all sources | 2011-06-30 | $847,705 |
| Expenses. Total of all expenses incurred | 2011-06-30 | $393,232 |
| Benefits paid (including direct rollovers) | 2011-06-30 | $376,747 |
| Total plan assets at end of year | 2011-06-30 | $3,576,084 |
| Total plan assets at beginning of year | 2011-06-30 | $2,899,730 |
| Value of fidelity bond covering the plan | 2011-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2011-06-30 | $47,705 |
| Expenses. Other expenses not covered elsewhere | 2011-06-30 | $16,485 |
| Net income (gross income less expenses) | 2011-06-30 | $454,473 |
| Net plan assets at end of year (total assets less liabilities) | 2011-06-30 | $3,576,084 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-06-30 | $2,890,146 |
| Total contributions received or receivable from employer(s) | 2011-06-30 | $800,000 |
| 2017: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan funding arrangement – Trust | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement - Trust | Yes |
| 2016: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan funding arrangement – Trust | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement - Trust | Yes |
| 2015: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan funding arrangement – Trust | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement - Trust | Yes |
| 2014: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | No |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan funding arrangement – Trust | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement - Trust | Yes |
| 2013: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan funding arrangement – Trust | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement - Trust | Yes |
| 2012: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan funding arrangement – Trust | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement - Trust | Yes |
| 2011: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan funding arrangement – Trust | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement - Trust | Yes |
| 2009: HY-LINE VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION PLAN AND TRUST 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan funding arrangement – Trust | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement - Trust | Yes |
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 61845/17467 |
| Policy instance | 1 |
| Insurance contract or identification number | 61845/17467 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $18,861 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $234,639 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,861 | | Insurance broker organization code? | 3 | | Insurance broker name | TRUE NORTH COMPANIES LC |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 75417/17467 |
| Policy instance | 1 |
| Insurance contract or identification number | 75417/17467 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $18,414 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $217,952 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,414 | | Insurance broker organization code? | 3 | | Insurance broker name | FRANK BERLIN & ASSOCIATES LLC |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 75417 |
| Policy instance | 1 |
| Insurance contract or identification number | 75417 | | Number of Individuals Covered | 104 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $18,990 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $217,799 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,990 | | Insurance broker organization code? | 3 | | Insurance broker name | FRANK BERLIN & ASSOCIATES LLC |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 75417 |
| Policy instance | 1 |
| Insurance contract or identification number | 75417 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $19,936 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $227,494 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,936 | | Insurance broker organization code? | 3 | | Insurance broker name | FRANK W BERLIN & ASSOCIATES LLC |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 75417 |
| Policy instance | 1 |
| Insurance contract or identification number | 75417 | | Number of Individuals Covered | 107 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $21,702 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $239,858 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,702 | | Insurance broker organization code? | 3 | | Insurance broker name | FRANK W BERLIN & ASSOCIATES LLC |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 75417 |
| Policy instance | 1 |
| Insurance contract or identification number | 75417 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $21,338 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $235,631 | | 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 | 75417 |
| Policy instance | 1 |
| Insurance contract or identification number | 75417 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $19,435 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $216,445 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
