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THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 401k Plan overview

Plan NameTHE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN
Plan identification number 502

THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Other welfare benefit cover

401k Sponsoring company profile

MOORE FANS LLC has sponsored the creation of one or more 401k plans.

Company Name:MOORE FANS LLC
Employer identification number (EIN):431947877
NAIC Classification:333410

Additional information about MOORE FANS LLC

Jurisdiction of Incorporation: Missouri Secretary of State
Incorporation Date:
Company Identification Number: LC0058672

More information about MOORE FANS LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01
5022017-01-01ALLISON THURMAN ALLISON THURMAN2018-07-26
5022016-01-01KRISTIN ALLEN KRISTIN ALLEN2017-07-25
5022015-01-01KRISTIN ALLEN KRISTIN ALLEN2016-07-18
5022014-01-01KRISTIN ALLEN KRISTIN ALLEN2015-07-27
5022013-01-01KRISTIN ALLEN KRISTIN ALLEN2014-07-16
5022012-01-01SHARON MOORE
5022011-01-01SHARON MOORE
5022009-01-01SHARON MOORE
5022007-01-01SHARON MOORE
5022006-01-01 SHARON MOORE2010-05-11

Plan Statistics for THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN

401k plan membership statisitcs for THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2022: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0164
Total number of active participants reported on line 7a of the Form 55002022-01-0169
Total of all active and inactive participants2022-01-0169
2021: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0164
Total number of active participants reported on line 7a of the Form 55002021-01-0164
Total of all active and inactive participants2021-01-0164
2020: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0167
Total number of active participants reported on line 7a of the Form 55002020-01-0164
Total of all active and inactive participants2020-01-0164
2019: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0165
Total number of active participants reported on line 7a of the Form 55002019-01-0167
Total of all active and inactive participants2019-01-0167
2018: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0165
Total number of active participants reported on line 7a of the Form 55002018-01-0165
Total of all active and inactive participants2018-01-0165
Total participants2018-01-0165
2017: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0165
Total number of active participants reported on line 7a of the Form 55002017-01-0165
Total of all active and inactive participants2017-01-0165
Total participants2017-01-0165
2016: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0163
Total number of active participants reported on line 7a of the Form 55002016-01-0165
Total of all active and inactive participants2016-01-0165
Total participants2016-01-0165
2015: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0164
Total number of active participants reported on line 7a of the Form 55002015-01-0163
Total of all active and inactive participants2015-01-0163
Total participants2015-01-0163
2014: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0157
Total number of active participants reported on line 7a of the Form 55002014-01-0164
Total of all active and inactive participants2014-01-0164
Total participants2014-01-0164
2013: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0157
Total number of active participants reported on line 7a of the Form 55002013-01-0157
Total of all active and inactive participants2013-01-0157
Total participants2013-01-0157
2012: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0158
Total number of active participants reported on line 7a of the Form 55002012-01-0157
Total of all active and inactive participants2012-01-0157
Total participants2012-01-0157
2011: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0159
Total number of active participants reported on line 7a of the Form 55002011-01-0158
Total of all active and inactive participants2011-01-0158
Total participants2011-01-0158
2009: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0156
Total number of active participants reported on line 7a of the Form 55002009-01-0153
Number of retired or separated participants receiving benefits2009-01-012
Total of all active and inactive participants2009-01-0155
Total participants2009-01-0155
2007: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-0153
Total number of active participants reported on line 7a of the Form 55002007-01-0156
Number of retired or separated participants receiving benefits2007-01-011
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-0157
Total participants2007-01-0157
2006: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-0151
Total number of active participants reported on line 7a of the Form 55002006-01-0153
Total of all active and inactive participants2006-01-0153
Total participants2006-01-0153

Financial Data on THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2022 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2022 401k financial data
Total income from all sources2022-12-31$798,654
Expenses. Total of all expenses incurred2022-12-31$795,400
Benefits paid (including direct rollovers)2022-12-31$522,516
Total plan assets at end of year2022-12-31$3,975
Total plan assets at beginning of year2022-12-31$721
Value of fidelity bond covering the plan2022-12-31$1,000,000
Total contributions received or receivable from participants2022-12-31$795,182
Expenses. Other expenses not covered elsewhere2022-12-31$272,884
Other income received2022-12-31$3,472
Net income (gross income less expenses)2022-12-31$3,254
Net plan assets at end of year (total assets less liabilities)2022-12-31$3,975
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$721
2021 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2021 401k financial data
Total income from all sources2021-12-31$1,078,632
Expenses. Total of all expenses incurred2021-12-31$1,080,925
Benefits paid (including direct rollovers)2021-12-31$862,548
Total plan assets at end of year2021-12-31$721
Total plan assets at beginning of year2021-12-31$3,014
Value of fidelity bond covering the plan2021-12-31$1,000,000
Total contributions received or receivable from participants2021-12-31$747,315
Expenses. Other expenses not covered elsewhere2021-12-31$218,377
Other income received2021-12-31$212,317
Net income (gross income less expenses)2021-12-31$-2,293
Net plan assets at end of year (total assets less liabilities)2021-12-31$721
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$3,014
Total contributions received or receivable from employer(s)2021-12-31$119,000
2020 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2020 401k financial data
Total income from all sources2020-12-31$890,788
Expenses. Total of all expenses incurred2020-12-31$888,945
Benefits paid (including direct rollovers)2020-12-31$687,579
Total plan assets at end of year2020-12-31$3,014
Total plan assets at beginning of year2020-12-31$1,171
Value of fidelity bond covering the plan2020-12-31$1,000,000
Total contributions received or receivable from participants2020-12-31$799,710
Expenses. Other expenses not covered elsewhere2020-12-31$201,366
Other income received2020-12-31$15,916
Net income (gross income less expenses)2020-12-31$1,843
Net plan assets at end of year (total assets less liabilities)2020-12-31$3,014
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,171
Total contributions received or receivable from employer(s)2020-12-31$75,162
2019 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2019 401k financial data
Total income from all sources2019-12-31$974,342
Expenses. Total of all expenses incurred2019-12-31$985,714
Benefits paid (including direct rollovers)2019-12-31$774,155
Total plan assets at end of year2019-12-31$1,171
Total plan assets at beginning of year2019-12-31$12,543
Value of fidelity bond covering the plan2019-12-31$1,000,000
Total contributions received or receivable from participants2019-12-31$728,419
Expenses. Other expenses not covered elsewhere2019-12-31$211,559
Other income received2019-12-31$45,923
Net income (gross income less expenses)2019-12-31$-11,372
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,171
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$12,543
Total contributions received or receivable from employer(s)2019-12-31$200,000
2018 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2018 401k financial data
Total income from all sources2018-12-31$922,681
Expenses. Total of all expenses incurred2018-12-31$914,844
Benefits paid (including direct rollovers)2018-12-31$737,850
Total plan assets at end of year2018-12-31$12,543
Total plan assets at beginning of year2018-12-31$4,706
Value of fidelity bond covering the plan2018-12-31$1,000,000
Total contributions received or receivable from participants2018-12-31$730,539
Expenses. Other expenses not covered elsewhere2018-12-31$176,994
Other income received2018-12-31$167,142
Net income (gross income less expenses)2018-12-31$7,837
Net plan assets at end of year (total assets less liabilities)2018-12-31$12,543
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$4,706
Total contributions received or receivable from employer(s)2018-12-31$25,000
2017 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2017 401k financial data
Total income from all sources2017-12-31$728,437
Expenses. Total of all expenses incurred2017-12-31$906,712
Benefits paid (including direct rollovers)2017-12-31$729,387
Total plan assets at end of year2017-12-31$4,706
Total plan assets at beginning of year2017-12-31$182,981
Value of fidelity bond covering the plan2017-12-31$1,000,000
Total contributions received or receivable from participants2017-12-31$723,597
Other income received2017-12-31$4,840
Net income (gross income less expenses)2017-12-31$-178,275
Net plan assets at end of year (total assets less liabilities)2017-12-31$4,706
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$182,981
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$177,325
2016 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2016 401k financial data
Total income from all sources2016-12-31$777,102
Expenses. Total of all expenses incurred2016-12-31$677,316
Benefits paid (including direct rollovers)2016-12-31$515,759
Total plan assets at end of year2016-12-31$182,981
Total plan assets at beginning of year2016-12-31$83,195
Value of fidelity bond covering the plan2016-12-31$1,000,000
Total contributions received or receivable from participants2016-12-31$734,119
Other income received2016-12-31$42,983
Net income (gross income less expenses)2016-12-31$99,786
Net plan assets at end of year (total assets less liabilities)2016-12-31$182,981
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$83,195
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$161,557
2015 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2015 401k financial data
Total income from all sources2015-12-31$1,087,340
Expenses. Total of all expenses incurred2015-12-31$1,216,880
Benefits paid (including direct rollovers)2015-12-31$1,077,313
Total plan assets at end of year2015-12-31$83,195
Total plan assets at beginning of year2015-12-31$212,735
Value of fidelity bond covering the plan2015-12-31$1,000,000
Total contributions received or receivable from participants2015-12-31$723,587
Other income received2015-12-31$363,753
Net income (gross income less expenses)2015-12-31$-129,540
Net plan assets at end of year (total assets less liabilities)2015-12-31$83,195
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$212,735
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$139,567
2014 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2014 401k financial data
Total income from all sources2014-12-31$707,242
Expenses. Total of all expenses incurred2014-12-31$503,331
Benefits paid (including direct rollovers)2014-12-31$400,082
Total plan assets at end of year2014-12-31$212,735
Total plan assets at beginning of year2014-12-31$8,824
Value of fidelity bond covering the plan2014-12-31$1,000,000
Total contributions received or receivable from participants2014-12-31$698,876
Other income received2014-12-31$8,366
Net income (gross income less expenses)2014-12-31$203,911
Net plan assets at end of year (total assets less liabilities)2014-12-31$212,735
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$8,824
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$103,249
2013 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2013 401k financial data
Total income from all sources2013-12-31$678,807
Expenses. Total of all expenses incurred2013-12-31$674,089
Benefits paid (including direct rollovers)2013-12-31$558,331
Total plan assets at end of year2013-12-31$8,824
Total plan assets at beginning of year2013-12-31$4,106
Value of fidelity bond covering the plan2013-12-31$1,000,000
Total contributions received or receivable from participants2013-12-31$629,626
Other income received2013-12-31$24,981
Net income (gross income less expenses)2013-12-31$4,718
Net plan assets at end of year (total assets less liabilities)2013-12-31$8,824
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$4,106
Total contributions received or receivable from employer(s)2013-12-31$24,200
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$115,758
2012 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2012 401k financial data
Total income from all sources2012-12-31$729,431
Expenses. Total of all expenses incurred2012-12-31$729,672
Benefits paid (including direct rollovers)2012-12-31$627,946
Total plan assets at end of year2012-12-31$4,106
Total plan assets at beginning of year2012-12-31$4,347
Total contributions received or receivable from participants2012-12-31$594,756
Other income received2012-12-31$34,675
Net income (gross income less expenses)2012-12-31$-241
Net plan assets at end of year (total assets less liabilities)2012-12-31$4,106
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$4,347
Total contributions received or receivable from employer(s)2012-12-31$100,000
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$101,726
2011 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2011 401k financial data
Total income from all sources2011-12-31$528,801
Expenses. Total of all expenses incurred2011-12-31$525,042
Benefits paid (including direct rollovers)2011-12-31$406,552
Total plan assets at end of year2011-12-31$4,347
Total plan assets at beginning of year2011-12-31$588
Value of fidelity bond covering the plan2011-12-31$1,000,000
Total contributions received or receivable from participants2011-12-31$528,801
Expenses. Other expenses not covered elsewhere2011-12-31$20
Net income (gross income less expenses)2011-12-31$3,759
Net plan assets at end of year (total assets less liabilities)2011-12-31$4,347
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$588
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$118,470
2010 : THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2010 401k financial data
Total income from all sources2010-12-31$748,691
Expenses. Total of all expenses incurred2010-12-31$754,724
Benefits paid (including direct rollovers)2010-12-31$655,394
Total plan assets at end of year2010-12-31$588
Total plan assets at beginning of year2010-12-31$6,621
Value of fidelity bond covering the plan2010-12-31$1,000,000
Total contributions received or receivable from participants2010-12-31$468,965
Other income received2010-12-31$155,226
Net income (gross income less expenses)2010-12-31$-6,033
Net plan assets at end of year (total assets less liabilities)2010-12-31$588
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$6,621
Total contributions received or receivable from employer(s)2010-12-31$124,500
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$99,330

Form 5500 Responses for THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN

2022: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: THE MOORE GROUP EMPLOYEE HEALTH 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 – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
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 – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: THE MOORE GROUP EMPLOYEE HEALTH 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 – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2009: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes
2007: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – TrustYes
2007-01-01Plan benefit arrangement - TrustYes
2006: THE MOORE GROUP EMPLOYEE HEALTH BENEFIT PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – TrustYes
2006-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5984535
Policy instance 5
Insurance contract or identification number5984535
Number of Individuals Covered252
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,616
Total amount of fees paid to insurance companyUSD $306
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 CarrierUSD $16,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,616
Insurance broker organization code?3
Amount paid for insurance broker fees306
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
PARTNERSMGU (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberM8044
Policy instance 4
Insurance contract or identification numberM8044
Number of Individuals Covered69
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
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
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 CarrierUSD $180,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number01221300
Policy instance 3
Insurance contract or identification number01221300
Number of Individuals Covered155
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,993
Total amount of fees paid to insurance companyUSD $12
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $31,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,993
Amount paid for insurance broker fees12
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS1573300
Policy instance 2
Insurance contract or identification numberUS1573300
Number of Individuals Covered69
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OPTUMHEALTH, A DIVISION OF UNITED HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered69
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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 providedORGAN TRANSPLANT
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 CarrierUSD $7,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5984535
Policy instance 1
Insurance contract or identification number5984535
Number of Individuals Covered245
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,677
Total amount of fees paid to insurance companyUSD $342
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 CarrierUSD $14,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,677
Amount paid for insurance broker fees54
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS1181240
Policy instance 2
Insurance contract or identification numberUS1181240
Number of Individuals Covered64
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARTNERSMGU (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberM8044
Policy instance 3
Insurance contract or identification numberM8044
Number of Individuals Covered64
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
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
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 CarrierUSD $167,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS1181240
Policy instance 3
Insurance contract or identification numberUS1181240
Number of Individuals Covered64
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5984535
Policy instance 2
Insurance contract or identification number5984535
Number of Individuals Covered247
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,445
Total amount of fees paid to insurance companyUSD $53
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 CarrierUSD $17,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $734
Amount paid for insurance broker fees41
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
PARTNERSMGU (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberM8044
Policy instance 1
Insurance contract or identification numberM8044
Number of Individuals Covered64
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
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
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 CarrierUSD $145,483
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5984535
Policy instance 2
Insurance contract or identification number5984535
Number of Individuals Covered248
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,700
Total amount of fees paid to insurance companyUSD $41
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 CarrierUSD $14,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,700
Amount paid for insurance broker fees41
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENATION
Insurance broker organization code?3
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS1181240
Policy instance 1
Insurance contract or identification numberUS1181240
Number of Individuals Covered65
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38776 )
Policy contract numberIMG-01419-17
Policy instance 1
Insurance contract or identification numberIMG-01419-17
Number of Individuals Covered65
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $24,833
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
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 CarrierUSD $130,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5227
Additional information about fees paid to insurance brokerAGENT COMMISSION
Insurance broker organization code?3
Insurance broker nameDEREN FINANCIAL GROUP
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number48343
Policy instance 1
Insurance contract or identification number48343
Number of Individuals Covered63
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $14,334
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
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 CarrierUSD $95,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees14334
Additional information about fees paid to insurance brokerLOCATE AND NEGOTIATE REINSURANCE COVERAGE
Insurance broker organization code?3
Insurance broker nameDEREN FINANCIAL GROUP
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number48343
Policy instance 1
Insurance contract or identification number48343
Number of Individuals Covered64
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,448
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
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 CarrierUSD $69,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees10448
Additional information about fees paid to insurance brokerLOCATE AND NEGOTIATE REINSURANCE COVERAGE
Insurance broker organization code?3
Insurance broker nameDEREN FINANCIAL GROUP
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL19162
Policy instance 1
Insurance contract or identification numberHCL19162
Number of Individuals Covered57
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $12,604
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 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
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 CarrierUSD $84,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees12604
Additional information about fees paid to insurance brokerLOCATE AND NEGOTIATE REINSURANCE COVERAGE
Insurance broker organization code?3
Insurance broker nameDEREN FINANCIAL GROUP
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL19162
Policy instance 1
Insurance contract or identification numberHCL19162
Number of Individuals Covered57
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,901
Welfare Benefit Premiums Paid to CarrierUSD $72,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees10901
Additional information about fees paid to insurance brokerLOCATE AND NEGOTIATE REINSURANCE COVERAGE
Insurance broker organization code?3
Insurance broker nameDEREN FINANCIAL GROUP
PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 )
Policy contract numberPX00612
Policy instance 1
Insurance contract or identification numberPX00612
Number of Individuals Covered58
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $13,187
Welfare Benefit Premiums Paid to CarrierUSD $87,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 )
Policy contract numberPX 00612
Policy instance 1
Insurance contract or identification numberPX 00612
Number of Individuals Covered59
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $10,803
Welfare Benefit Premiums Paid to CarrierUSD $71,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,803
Insurance broker nameDEREN FINANCIAL GROUP

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