PARK UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PARK UNIVERSITY WELFARE BENEFITS PLAN
Measure | Date | Value |
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2022: PARK UNIVERSITY WELFARE BENEFITS PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 520 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 403 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 403 |
2021: PARK UNIVERSITY WELFARE BENEFITS PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 498 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 470 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 50 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 520 |
2020: PARK UNIVERSITY WELFARE BENEFITS PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-03-01 | 535 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 469 |
Number of retired or separated participants receiving benefits | 2020-03-01 | 29 |
Number of other retired or separated participants entitled to future benefits | 2020-03-01 | 0 |
Total of all active and inactive participants | 2020-03-01 | 498 |
2019: PARK UNIVERSITY WELFARE BENEFITS PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-03-01 | 537 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 513 |
Number of retired or separated participants receiving benefits | 2019-03-01 | 22 |
Number of other retired or separated participants entitled to future benefits | 2019-03-01 | 0 |
Total of all active and inactive participants | 2019-03-01 | 535 |
2018: PARK UNIVERSITY WELFARE BENEFITS PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-03-01 | 477 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 535 |
Number of retired or separated participants receiving benefits | 2018-03-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2018-03-01 | 0 |
Total of all active and inactive participants | 2018-03-01 | 537 |
2017: PARK UNIVERSITY WELFARE BENEFITS PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-03-01 | 492 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 477 |
Number of retired or separated participants receiving benefits | 2017-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-03-01 | 0 |
Total of all active and inactive participants | 2017-03-01 | 477 |
Total participants, beginning-of-year | 2017-02-01 | 492 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 477 |
Number of retired or separated participants receiving benefits | 2017-02-01 | 17 |
Number of other retired or separated participants entitled to future benefits | 2017-02-01 | 0 |
Total of all active and inactive participants | 2017-02-01 | 494 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-02-01 | 0 |
Total participants | 2017-02-01 | 494 |
Number of participants with account balances | 2017-02-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-02-01 | 0 |
2016: PARK UNIVERSITY WELFARE BENEFITS PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-02-01 | 473 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 475 |
Number of retired or separated participants receiving benefits | 2016-02-01 | 17 |
Number of other retired or separated participants entitled to future benefits | 2016-02-01 | 0 |
Total of all active and inactive participants | 2016-02-01 | 492 |
2015: PARK UNIVERSITY WELFARE BENEFITS PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-02-01 | 554 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 457 |
Number of retired or separated participants receiving benefits | 2015-02-01 | 16 |
Number of other retired or separated participants entitled to future benefits | 2015-02-01 | 0 |
Total of all active and inactive participants | 2015-02-01 | 473 |
2014: PARK UNIVERSITY WELFARE BENEFITS PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-02-01 | 590 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 539 |
Number of retired or separated participants receiving benefits | 2014-02-01 | 10 |
Number of other retired or separated participants entitled to future benefits | 2014-02-01 | 0 |
Total of all active and inactive participants | 2014-02-01 | 549 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-02-01 | 0 |
Total participants | 2014-02-01 | 549 |
Number of participants with account balances | 2014-02-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-02-01 | 0 |
Number of employers contributing to the scheme | 2014-02-01 | 0 |
2013: PARK UNIVERSITY WELFARE BENEFITS PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-02-01 | 554 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 577 |
Number of retired or separated participants receiving benefits | 2013-02-01 | 13 |
Number of other retired or separated participants entitled to future benefits | 2013-02-01 | 0 |
Total of all active and inactive participants | 2013-02-01 | 590 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-02-01 | 0 |
Total participants | 2013-02-01 | 590 |
Number of participants with account balances | 2013-02-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-02-01 | 0 |
Number of employers contributing to the scheme | 2013-02-01 | 0 |
2012: PARK UNIVERSITY WELFARE BENEFITS PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-02-01 | 522 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 535 |
Number of retired or separated participants receiving benefits | 2012-02-01 | 19 |
Number of other retired or separated participants entitled to future benefits | 2012-02-01 | 0 |
Total of all active and inactive participants | 2012-02-01 | 554 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-02-01 | 0 |
Total participants | 2012-02-01 | 554 |
Number of participants with account balances | 2012-02-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-02-01 | 0 |
Number of employers contributing to the scheme | 2012-02-01 | 0 |
2011: PARK UNIVERSITY WELFARE BENEFITS PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-02-01 | 469 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 532 |
Number of retired or separated participants receiving benefits | 2011-02-01 | 14 |
Number of other retired or separated participants entitled to future benefits | 2011-02-01 | 0 |
Total of all active and inactive participants | 2011-02-01 | 546 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-02-01 | 0 |
Total participants | 2011-02-01 | 546 |
Number of participants with account balances | 2011-02-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-02-01 | 0 |
Number of employers contributing to the scheme | 2011-02-01 | 0 |
2022: PARK UNIVERSITY WELFARE BENEFITS PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2021: PARK UNIVERSITY WELFARE BENEFITS PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2020: PARK UNIVERSITY WELFARE BENEFITS PLAN 2020 form 5500 responses |
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2020-03-01 | Type of plan entity | Single employer plan |
2020-03-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2020-03-01 | Plan funding arrangement – Insurance | Yes |
2020-03-01 | Plan benefit arrangement – Insurance | Yes |
2019: PARK UNIVERSITY WELFARE BENEFITS PLAN 2019 form 5500 responses |
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2019-03-01 | Type of plan entity | Single employer plan |
2019-03-01 | Plan funding arrangement – Insurance | Yes |
2019-03-01 | Plan benefit arrangement – Insurance | Yes |
2018: PARK UNIVERSITY WELFARE BENEFITS PLAN 2018 form 5500 responses |
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2018-03-01 | Type of plan entity | Single employer plan |
2018-03-01 | Plan funding arrangement – Insurance | Yes |
2018-03-01 | Plan benefit arrangement – Insurance | Yes |
2017: PARK UNIVERSITY WELFARE BENEFITS PLAN 2017 form 5500 responses |
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2017-03-01 | Type of plan entity | Single employer plan |
2017-03-01 | Plan funding arrangement – Insurance | Yes |
2017-03-01 | Plan benefit arrangement – Insurance | Yes |
2017-02-01 | Type of plan entity | Single employer plan |
2017-02-01 | Submission has been amended | No |
2017-02-01 | This submission is the final filing | No |
2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2017-02-01 | Plan is a collectively bargained plan | No |
2017-02-01 | Plan funding arrangement – Insurance | Yes |
2017-02-01 | Plan benefit arrangement – Insurance | Yes |
2016: PARK UNIVERSITY WELFARE BENEFITS PLAN 2016 form 5500 responses |
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2016-02-01 | Type of plan entity | Single employer plan |
2016-02-01 | Plan funding arrangement – Insurance | Yes |
2016-02-01 | Plan benefit arrangement – Insurance | Yes |
2015: PARK UNIVERSITY WELFARE BENEFITS PLAN 2015 form 5500 responses |
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2015-02-01 | Type of plan entity | Single employer plan |
2015-02-01 | Plan funding arrangement – Insurance | Yes |
2015-02-01 | Plan benefit arrangement – Insurance | Yes |
2014: PARK UNIVERSITY WELFARE BENEFITS PLAN 2014 form 5500 responses |
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2014-02-01 | Type of plan entity | Single employer plan |
2014-02-01 | First time form 5500 has been submitted | Yes |
2014-02-01 | Submission has been amended | Yes |
2014-02-01 | This submission is the final filing | No |
2014-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-02-01 | Plan is a collectively bargained plan | No |
2014-02-01 | Plan funding arrangement – Insurance | Yes |
2014-02-01 | Plan benefit arrangement – Insurance | Yes |
2013: PARK UNIVERSITY WELFARE BENEFITS PLAN 2013 form 5500 responses |
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2013-02-01 | Type of plan entity | Single employer plan |
2013-02-01 | First time form 5500 has been submitted | Yes |
2013-02-01 | Submission has been amended | No |
2013-02-01 | This submission is the final filing | No |
2013-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-02-01 | Plan is a collectively bargained plan | No |
2013-02-01 | Plan funding arrangement – Insurance | Yes |
2013-02-01 | Plan benefit arrangement – Insurance | Yes |
2012: PARK UNIVERSITY WELFARE BENEFITS PLAN 2012 form 5500 responses |
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2012-02-01 | Type of plan entity | Single employer plan |
2012-02-01 | First time form 5500 has been submitted | Yes |
2012-02-01 | Submission has been amended | No |
2012-02-01 | This submission is the final filing | No |
2012-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-02-01 | Plan is a collectively bargained plan | No |
2012-02-01 | Plan funding arrangement – Insurance | Yes |
2012-02-01 | Plan benefit arrangement – Insurance | Yes |
2011: PARK UNIVERSITY WELFARE BENEFITS PLAN 2011 form 5500 responses |
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2011-02-01 | Type of plan entity | Single employer plan |
2011-02-01 | First time form 5500 has been submitted | Yes |
2011-02-01 | Submission has been amended | No |
2011-02-01 | This submission is the final filing | No |
2011-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-02-01 | Plan is a collectively bargained plan | No |
2011-02-01 | Plan funding arrangement – Insurance | Yes |
2011-02-01 | Plan benefit arrangement – Insurance | Yes |
2009: PARK UNIVERSITY WELFARE BENEFITS PLAN 2009 form 5500 responses |
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2009-02-01 | Type of plan entity | Single employer plan |
2009-02-01 | Submission has been amended | No |
2009-02-01 | This submission is the final filing | No |
2009-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-02-01 | Plan is a collectively bargained plan | No |
2009-02-01 | Plan funding arrangement – Insurance | Yes |
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
Policy contract number | 30089454 |
Policy instance | 5 |
Insurance contract or identification number | 30089454 | Number of Individuals Covered | 277 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,805 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 ) |
Policy contract number | GTA101229 |
Policy instance | 4 |
Insurance contract or identification number | GTA101229 | Number of Individuals Covered | 546 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-09-30 | Total amount of commissions paid to insurance broker | USD $113 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $750 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $113 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 3 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 354 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 43432000 |
Policy instance | 2 |
Insurance contract or identification number | 43432000 | Number of Individuals Covered | 550 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of fees paid to insurance company | USD $138 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,113,596 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 138 | Additional information about fees paid to insurance broker | 138 OTHER NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 1 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 403 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 1 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 470 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 43432000 |
Policy instance | 2 |
Insurance contract or identification number | 43432000 | Number of Individuals Covered | 1208 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,642,845 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 3 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 397 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 ) |
Policy contract number | GTA101229 |
Policy instance | 4 |
Insurance contract or identification number | GTA101229 | Number of Individuals Covered | 465 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-09-30 | Total amount of commissions paid to insurance broker | USD $113 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $750 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $113 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
Policy contract number | 30089454 |
Policy instance | 5 |
Insurance contract or identification number | 30089454 | Number of Individuals Covered | 320 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,506 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 1 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 469 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2020-12-31 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 43432000 |
Policy instance | 2 |
Insurance contract or identification number | 43432000 | Number of Individuals Covered | 617 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2020-12-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,681,246 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 3 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 413 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2020-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | GTA-101229 |
Policy instance | 4 |
Insurance contract or identification number | GTA-101229 | Number of Individuals Covered | 548 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $113 | Total amount of fees paid to insurance company | USD $1 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $750 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $113 | Amount paid for insurance broker fees | 1 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
Policy contract number | 30089454 |
Policy instance | 5 |
Insurance contract or identification number | 30089454 | Number of Individuals Covered | 328 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2020-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,072 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 1 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 284 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $96,193 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 43432000 |
Policy instance | 2 |
Insurance contract or identification number | 43432000 | Number of Individuals Covered | 611 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of fees paid to insurance company | USD $182 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,157,338 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 182 | Additional information about fees paid to insurance broker | OTHER NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 3 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 444 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB-133015 |
Policy instance | 4 |
Insurance contract or identification number | ETB-133015 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $122 | Total amount of fees paid to insurance company | USD $18 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $814 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $122 | Amount paid for insurance broker fees | 18 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
Policy contract number | 30089454 |
Policy instance | 6 |
Insurance contract or identification number | 30089454 | Number of Individuals Covered | 342 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,031 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 5 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 513 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $1,926 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $48,437 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,926 | Insurance broker organization code? | 3 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 1 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 290 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $86,853 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3340797 |
Policy instance | 2 |
Insurance contract or identification number | 3340797 | Number of Individuals Covered | 641 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of fees paid to insurance company | USD $1,826 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $994,463 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1826 | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 3 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 467 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB-133015 |
Policy instance | 4 |
Insurance contract or identification number | ETB-133015 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of fees paid to insurance company | USD $11 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 11 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 5 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 535 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $2,954 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $47,638 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,954 | Insurance broker organization code? | 3 |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 5 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 517 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $1,084 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $35,225 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,084 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB133015 |
Policy instance | 4 |
Insurance contract or identification number | ETB133015 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of fees paid to insurance company | USD $9 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 9 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 3 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 411 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3340797 |
Policy instance | 2 |
Insurance contract or identification number | 3340797 | Number of Individuals Covered | 599 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of fees paid to insurance company | USD $1,693 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Were dividends or retroactive rate refunds paid in cash? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $815,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1693 | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 1 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 277 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $83,363 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 3 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 385 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB-133015 |
Policy instance | 4 |
Insurance contract or identification number | ETB-133015 | Number of Individuals Covered | 567 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $113 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $750 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $113 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 5 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 457 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $8,526 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $52,033 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,526 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 1 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 220 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $7,101 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $104,243 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,101 | Insurance broker organization code? | 3 | Insurance broker name | AON CONSULTING INC |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3337782 |
Policy instance | 2 |
Insurance contract or identification number | 3337782 | Number of Individuals Covered | 528 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $118,755 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $421,509 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $59,023 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 3 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 452 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 | No | 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 | Yes | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3337782 |
Policy instance | 2 |
Insurance contract or identification number | 3337782 | Number of Individuals Covered | 651 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $154,874 | 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 | Yes | Vision Insurance Welfare Benefit | Yes | 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 $510,600 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $141,968 | Insurance broker organization code? | 3 | Insurance broker name | AON RISK SERVICES CENTRAL, INC |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 1 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 542 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $17,659 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | 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 $336,080 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other welfare benefits provided | AD&D | Commission paid to Insurance Broker | USD $17,659 | Insurance broker organization code? | 3 | Insurance broker name | AON CONSULTING INC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB-133015 |
Policy instance | 4 |
Insurance contract or identification number | ETB-133015 | Number of Individuals Covered | 535 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | 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 | No | 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 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | 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 $750 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Total amount of commissions paid to insurance broker | USD $112 | Commission paid to Insurance Broker | USD $112 | Insurance broker organization code? | 3 | Insurance broker name | AON CONSULTING INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0716421 |
Policy instance | 5 |
Insurance contract or identification number | 0716421 | Number of Individuals Covered | 712 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $13,896 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $346,443 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,896 | Insurance broker organization code? | 3 | Insurance broker name | AON RISK SERVICES |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 1 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 572 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $17,509 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | 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 $237,290 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,509 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AON CONSULTING INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0716421 |
Policy instance | 2 |
Insurance contract or identification number | 0716421 | Number of Individuals Covered | 1007 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $159,951 | 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 | Yes | Vision Insurance Welfare Benefit | Yes | 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 $3,978,218 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $159,951 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AON RISK SERVICES CENTRAL KC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 3 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 446 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 | No | 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 | Yes | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker name | NONE |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | EBT133015 |
Policy instance | 4 |
Insurance contract or identification number | EBT133015 | Number of Individuals Covered | 535 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $112 | Total amount of fees paid to insurance company | USD $0 | 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 | No | 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 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | 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 $750 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $112 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AON CONSULTING INC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | EBT133015 |
Policy instance | 6 |
Insurance contract or identification number | EBT133015 | Number of Individuals Covered | 535 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Total amount of commissions paid to insurance broker | USD $225 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $1,500 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $225 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AON CONSULTING INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0716421 |
Policy instance | 2 |
Insurance contract or identification number | 0716421 | Number of Individuals Covered | 359 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $148,561 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,662,036 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $148,561 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AON RISK SERVICES CENTRAL KC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0716421 |
Policy instance | 3 |
Insurance contract or identification number | 0716421 | Number of Individuals Covered | 248 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $3,374 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,477 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,374 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AON RISK SERVICES CENTRAL KC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 4 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 447 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker name | NONE |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 1 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 514 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $16,831 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $168,312 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,831 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AON CONSULTING INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0716421 |
Policy instance | 5 |
Insurance contract or identification number | 0716421 | Number of Individuals Covered | 294 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $16,406 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $190,508 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,406 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | SALES & SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AON RISK SERVCIES CENTRAL KC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 137185 |
Policy instance | 5 |
Insurance contract or identification number | 137185 | Number of Individuals Covered | 515 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 33146 |
Policy instance | 1 |
Insurance contract or identification number | 33146 | Number of Individuals Covered | 458 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $10,139 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $202,782 | 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 | 0716421 |
Policy instance | 3 |
Insurance contract or identification number | 0716421 | Number of Individuals Covered | 348 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $122,971 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,574,145 | 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 | 0716421 |
Policy instance | 4 |
Insurance contract or identification number | 0716421 | Number of Individuals Covered | 233 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $2,874 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $147,491 | 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 | 0716421 |
Policy instance | 2 |
Insurance contract or identification number | 0716421 | Number of Individuals Covered | 284 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $13,324 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $63,526 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|