WILLERT HOME PRODUCTS has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2021: WILLERT HOME PRODUCTS 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-11-01 | 187 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-11-01 | 174 |
| Total of all active and inactive participants | 2021-11-01 | 174 |
| 2020: WILLERT HOME PRODUCTS 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-11-01 | 167 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-11-01 | 187 |
| Total of all active and inactive participants | 2020-11-01 | 187 |
| 2019: WILLERT HOME PRODUCTS 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-11-01 | 159 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-11-01 | 167 |
| Total of all active and inactive participants | 2019-11-01 | 167 |
| 2018: WILLERT HOME PRODUCTS 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-11-01 | 141 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 159 |
| Total of all active and inactive participants | 2018-11-01 | 159 |
| 2017: WILLERT HOME PRODUCTS 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-11-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 141 |
| Total of all active and inactive participants | 2017-11-01 | 141 |
| 2016: WILLERT HOME PRODUCTS 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-11-01 | 245 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 147 |
| Total of all active and inactive participants | 2016-11-01 | 147 |
| 2015: WILLERT HOME PRODUCTS 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-11-01 | 240 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-11-01 | 245 |
| Total of all active and inactive participants | 2015-11-01 | 245 |
| 2014: WILLERT HOME PRODUCTS 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-11-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-11-01 | 240 |
| Total of all active and inactive participants | 2014-11-01 | 240 |
| 2013: WILLERT HOME PRODUCTS 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-11-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-11-01 | 147 |
| Total of all active and inactive participants | 2013-11-01 | 147 |
| 2012: WILLERT HOME PRODUCTS 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-11-01 | 149 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-11-01 | 163 |
| Total of all active and inactive participants | 2012-11-01 | 163 |
| 2011: WILLERT HOME PRODUCTS 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-11-01 | 148 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-11-01 | 149 |
| Total of all active and inactive participants | 2011-11-01 | 149 |
| 2009: WILLERT HOME PRODUCTS 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-11-01 | 173 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-11-01 | 182 |
| Number of retired or separated participants receiving benefits | 2009-11-01 | 1 |
| Total of all active and inactive participants | 2009-11-01 | 183 |
| 2021: WILLERT HOME PRODUCTS 2021 form 5500 responses |
|---|
| 2021-11-01 | Type of plan entity | Single employer plan |
| 2021-11-01 | Plan funding arrangement – Insurance | Yes |
| 2021-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: WILLERT HOME PRODUCTS 2020 form 5500 responses |
|---|
| 2020-11-01 | Type of plan entity | Single employer plan |
| 2020-11-01 | Plan funding arrangement – Insurance | Yes |
| 2020-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: WILLERT HOME PRODUCTS 2019 form 5500 responses |
|---|
| 2019-11-01 | Type of plan entity | Single employer plan |
| 2019-11-01 | Plan funding arrangement – Insurance | Yes |
| 2019-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: WILLERT HOME PRODUCTS 2018 form 5500 responses |
|---|
| 2018-11-01 | Type of plan entity | Single employer plan |
| 2018-11-01 | Plan funding arrangement – Insurance | Yes |
| 2018-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: WILLERT HOME PRODUCTS 2017 form 5500 responses |
|---|
| 2017-11-01 | Type of plan entity | Single employer plan |
| 2017-11-01 | Plan funding arrangement – Insurance | Yes |
| 2017-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: WILLERT HOME PRODUCTS 2016 form 5500 responses |
|---|
| 2016-11-01 | Type of plan entity | Single employer plan |
| 2016-11-01 | Plan funding arrangement – Insurance | Yes |
| 2016-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: WILLERT HOME PRODUCTS 2015 form 5500 responses |
|---|
| 2015-11-01 | Type of plan entity | Single employer plan |
| 2015-11-01 | Plan funding arrangement – Insurance | Yes |
| 2015-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: WILLERT HOME PRODUCTS 2014 form 5500 responses |
|---|
| 2014-11-01 | Type of plan entity | Single employer plan |
| 2014-11-01 | Plan funding arrangement – Insurance | Yes |
| 2014-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: WILLERT HOME PRODUCTS 2013 form 5500 responses |
|---|
| 2013-11-01 | Type of plan entity | Single employer plan |
| 2013-11-01 | Plan funding arrangement – Insurance | Yes |
| 2013-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: WILLERT HOME PRODUCTS 2012 form 5500 responses |
|---|
| 2012-11-01 | Type of plan entity | Single employer plan |
| 2012-11-01 | Plan funding arrangement – Insurance | Yes |
| 2012-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: WILLERT HOME PRODUCTS 2011 form 5500 responses |
|---|
| 2011-11-01 | Type of plan entity | Single employer plan |
| 2011-11-01 | Plan funding arrangement – Insurance | Yes |
| 2011-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: WILLERT HOME PRODUCTS 2009 form 5500 responses |
|---|
| 2009-11-01 | Type of plan entity | Single employer plan |
| 2009-11-01 | This submission is the final filing | No |
| 2009-11-01 | Plan funding arrangement – Insurance | Yes |
| 2009-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: WILLERT HOME PRODUCTS 2008 form 5500 responses |
|---|
| 2008-11-01 | Type of plan entity | Single employer plan |
| 2008-11-01 | Submission has been amended | No |
| 2008-11-01 | This submission is the final filing | No |
| 2008-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-11-01 | Plan is a collectively bargained plan | No |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0BG2L |
| Policy instance | 5 |
| Insurance contract or identification number | GLUG0BG2L | | Number of Individuals Covered | 225 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-11-01 | | Total amount of commissions paid to insurance broker | USD $304 | | Total amount of fees paid to insurance company | USD $672 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $10,121 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 672 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $304 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0BG2L |
| Policy instance | 4 |
| Insurance contract or identification number | GLTD0BG2L | | Number of Individuals Covered | 44 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-11-01 | | Total amount of commissions paid to insurance broker | USD $209 | | Total amount of fees paid to insurance company | USD $469 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,979 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $209 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 469 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL34441 |
| Policy instance | 3 |
| Insurance contract or identification number | HCL34441 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $17,712 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $354,235 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,712 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 717881 |
| Policy instance | 2 |
| Insurance contract or identification number | 717881 | | Number of Individuals Covered | 329 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $1,168 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,744 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,168 | | Insurance broker organization code? | 3 |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 6410-0886 |
| Policy instance | 1 |
| Insurance contract or identification number | 6410-0886 | | Number of Individuals Covered | 229 | | Insurance policy start date | 2021-03-05 | | Insurance policy end date | 2022-03-05 | | Total amount of commissions paid to insurance broker | USD $1,861 | | Total amount of fees paid to insurance company | USD $2,482 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $12,408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2482 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $1,861 |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 6410-0886 |
| Policy instance | 1 |
| Insurance contract or identification number | 6410-0886 | | Number of Individuals Covered | 251 | | Insurance policy start date | 2020-03-05 | | Insurance policy end date | 2021-03-05 | | Total amount of commissions paid to insurance broker | USD $1,851 | | Total amount of fees paid to insurance company | USD $2,468 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $12,341 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2468 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $1,851 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 717881 |
| Policy instance | 2 |
| Insurance contract or identification number | 717881 | | Number of Individuals Covered | 374 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $1,314 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,117 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,314 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL34441 |
| Policy instance | 3 |
| Insurance contract or identification number | HCL34441 | | Number of Individuals Covered | 187 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $17,933 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $358,657 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,933 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0BG2L |
| Policy instance | 4 |
| Insurance contract or identification number | GLTD0BG2L | | Number of Individuals Covered | 51 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-11-01 | | Total amount of commissions paid to insurance broker | USD $213 | | Total amount of fees paid to insurance company | USD $417 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,088 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $213 | | Amount paid for insurance broker fees | 417 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0BG2L |
| Policy instance | 5 |
| Insurance contract or identification number | GLUG0BG2L | | Number of Individuals Covered | 241 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-11-01 | | Total amount of commissions paid to insurance broker | USD $303 | | Total amount of fees paid to insurance company | USD $454 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $10,107 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $303 | | Amount paid for insurance broker fees | 454 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL34441 |
| Policy instance | 5 |
| Insurance contract or identification number | HCL34441 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $9,815 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $280,001 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,815 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BG2L |
| Policy instance | 4 |
| Insurance contract or identification number | G000BG2L | | Number of Individuals Covered | 203 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-11-01 | | Total amount of commissions paid to insurance broker | USD $208 | | Total amount of fees paid to insurance company | USD $397 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $6,944 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 397 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $208 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 717881 |
| Policy instance | 3 |
| Insurance contract or identification number | 717881 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $1,083 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,933 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,083 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BG2L |
| Policy instance | 2 |
| Insurance contract or identification number | G000BG2L | | Number of Individuals Covered | 45 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-11-01 | | Total amount of commissions paid to insurance broker | USD $204 | | Total amount of fees paid to insurance company | USD $409 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,809 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 409 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $204 |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 6410-0886 |
| Policy instance | 1 |
| Insurance contract or identification number | 6410-0886 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2019-03-05 | | Insurance policy end date | 2020-03-05 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 32395 ) |
| Policy contract number | 717881 |
| Policy instance | 2 |
| Insurance contract or identification number | 717881 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $1,055 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,549 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,055 | | Insurance broker organization code? | 3 |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 6410-0886 |
| Policy instance | 1 |
| Insurance contract or identification number | 6410-0886 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2018-03-05 | | Insurance policy end date | 2019-03-05 | | Total amount of commissions paid to insurance broker | USD $6 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $17 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BG2L |
| Policy instance | 3 |
| Insurance contract or identification number | G000BG2L | | Number of Individuals Covered | 45 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-11-01 | | Total amount of commissions paid to insurance broker | USD $175 | | Total amount of fees paid to insurance company | USD $299 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,827 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 299 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $175 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BG2L |
| Policy instance | 4 |
| Insurance contract or identification number | G000BG2L | | Number of Individuals Covered | 194 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-11-01 | | Total amount of commissions paid to insurance broker | USD $172 | | Total amount of fees paid to insurance company | USD $311 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $5,739 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 311 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $172 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL34441 |
| Policy instance | 5 |
| Insurance contract or identification number | HCL34441 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $7,567 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $252,224 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,421 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 600501 |
| Policy instance | 4 |
| Insurance contract or identification number | 600501 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $261,891 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 717881 |
| Policy instance | 3 |
| Insurance contract or identification number | 717881 | | Number of Individuals Covered | 243 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,182 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 094799 |
| Policy instance | 2 |
| Insurance contract or identification number | 094799 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2017-11-02 | | Insurance policy end date | 2018-11-02 | | Total amount of commissions paid to insurance broker | USD $1,749 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $11,192 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | 6410-0886 |
| Policy instance | 1 |
| Insurance contract or identification number | 6410-0886 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2017-03-05 | | Insurance policy end date | 2018-03-05 | | Total amount of commissions paid to insurance broker | USD $6,223 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $17,778 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
