401k Plan data: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN plan

BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN
Plan identification number	501

BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

BUTTERFIELD YOUTH SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: BUTTERFIELD YOUTH SERVICES, INC.

Employer identification number (EIN): 440668473

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-04-01 LEROY NUNN
501 2014-04-01 LEROY NUNN
501 2013-04-01 MIKE SCHUBACH
501 2012-04-01 MIKE SCHUBACH
501 2011-04-01 MIKE SCHUBACH
501 2010-04-01 MIKE SCHUBACH
501 2009-04-01 MELINDA BEELER MELINDA BEELER 2010-10-28
501 2009-04-01 MIKE SCHUBACH MIKE SCHUBACH 2014-05-19

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2015-04-01	LEROY NUNN
501	2014-04-01	LEROY NUNN
501	2013-04-01	MIKE SCHUBACH
501	2012-04-01	MIKE SCHUBACH
501	2011-04-01	MIKE SCHUBACH
501	2010-04-01	MIKE SCHUBACH
501	2009-04-01	MELINDA BEELER	MELINDA BEELER	2010-10-28
501	2009-04-01	MIKE SCHUBACH	MIKE SCHUBACH	2014-05-19

Plan Statistics for BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN

Measure Date Value
2015: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-04-01 93
Total number of active participants reported on line 7a of the Form 5500 2015-04-01 0
Number of retired or separated participants receiving benefits 2015-04-01 0
Number of other retired or separated participants entitled to future benefits 2015-04-01 0
Total of all active and inactive participants 2015-04-01 0
2014: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-04-01 114
Total number of active participants reported on line 7a of the Form 5500 2014-04-01 100
Number of retired or separated participants receiving benefits 2014-04-01 0
Number of other retired or separated participants entitled to future benefits 2014-04-01 0
Total of all active and inactive participants 2014-04-01 100
2013: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-04-01 114
Total number of active participants reported on line 7a of the Form 5500 2013-04-01 114
Total of all active and inactive participants 2013-04-01 114
2012: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-04-01 112
Total number of active participants reported on line 7a of the Form 5500 2012-04-01 114
Total of all active and inactive participants 2012-04-01 114
2011: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-04-01 112
Total number of active participants reported on line 7a of the Form 5500 2011-04-01 112
Total of all active and inactive participants 2011-04-01 112
2010: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-04-01 115
Total number of active participants reported on line 7a of the Form 5500 2010-04-01 112
Total of all active and inactive participants 2010-04-01 112
2009: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-04-01 114
Total number of active participants reported on line 7a of the Form 5500 2009-04-01 95
Total of all active and inactive participants 2009-04-01 95
Total participants 2009-04-01 95

Measure	Date	Value
2015: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-04-01	93
Total number of active participants reported on line 7a of the Form 5500	2015-04-01	0
Number of retired or separated participants receiving benefits	2015-04-01	0
Number of other retired or separated participants entitled to future benefits	2015-04-01	0
Total of all active and inactive participants	2015-04-01	0
2014: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-04-01	114
Total number of active participants reported on line 7a of the Form 5500	2014-04-01	100
Number of retired or separated participants receiving benefits	2014-04-01	0
Number of other retired or separated participants entitled to future benefits	2014-04-01	0
Total of all active and inactive participants	2014-04-01	100
2013: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-04-01	114
Total number of active participants reported on line 7a of the Form 5500	2013-04-01	114
Total of all active and inactive participants	2013-04-01	114
2012: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-04-01	112
Total number of active participants reported on line 7a of the Form 5500	2012-04-01	114
Total of all active and inactive participants	2012-04-01	114
2011: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-04-01	112
Total number of active participants reported on line 7a of the Form 5500	2011-04-01	112
Total of all active and inactive participants	2011-04-01	112
2010: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-04-01	115
Total number of active participants reported on line 7a of the Form 5500	2010-04-01	112
Total of all active and inactive participants	2010-04-01	112
2009: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-04-01	114
Total number of active participants reported on line 7a of the Form 5500	2009-04-01	95
Total of all active and inactive participants	2009-04-01	95
Total participants	2009-04-01	95

Form 5500 Responses for BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN

2015: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-04-01	Type of plan entity	Single employer plan
2015-04-01	Submission has been amended	No
2015-04-01	This submission is the final filing	Yes
2015-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-04-01	Plan is a collectively bargained plan	No
2015-04-01	Plan funding arrangement – Insurance	Yes
2015-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-04-01	Plan benefit arrangement – Insurance	Yes
2015-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-04-01	Type of plan entity	Single employer plan
2014-04-01	Plan funding arrangement – Insurance	Yes
2014-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-04-01	Plan benefit arrangement – Insurance	Yes
2014-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-04-01	Type of plan entity	Single employer plan
2013-04-01	Plan funding arrangement – Insurance	Yes
2013-04-01	Plan benefit arrangement – Insurance	Yes
2012: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-04-01	Type of plan entity	Single employer plan
2012-04-01	Plan funding arrangement – Insurance	Yes
2012-04-01	Plan benefit arrangement – Insurance	Yes
2011: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-04-01	Type of plan entity	Single employer plan
2011-04-01	Plan funding arrangement – Insurance	Yes
2011-04-01	Plan benefit arrangement – Insurance	Yes
2010: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2010 form 5500 responses
2010-04-01	Type of plan entity	Single employer plan
2010-04-01	Plan funding arrangement – Insurance	Yes
2010-04-01	Plan benefit arrangement – Insurance	Yes
2009: BUTTERFIELD YOUTH SERVICES EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-04-01	Type of plan entity	Single employer plan
2009-04-01	Submission has been amended	Yes
2009-04-01	This submission is the final filing	No
2009-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-04-01	Plan is a collectively bargained plan	No
2009-04-01	Plan funding arrangement – Insurance	Yes
2009-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10143404

Policy instance

Insurance contract or identification number	10143404
Number of Individuals Covered	88
Insurance policy start date	2014-12-01
Insurance policy end date	2015-11-30
Total amount of commissions paid to insurance broker	USD $4,205
Total amount of fees paid to insurance company	USD $198
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	Yes
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 $20,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,475
Amount paid for insurance broker fees	198
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Other welfare benefits provided	AD & D
Insurance broker name	JW TERRILL BENEFIT SERVICES INC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10143403

Policy instance

Insurance contract or identification number	10143403
Number of Individuals Covered	88
Insurance policy start date	2014-12-01
Insurance policy end date	2015-11-30
Total amount of commissions paid to insurance broker	USD $2,079
Total amount of fees paid to insurance company	USD $98
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
Welfare Benefit Premiums Paid to Carrier	USD $10,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,155
Amount paid for insurance broker fees	98
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	JW TERRILL BENEFIT SERVICES INC

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5468140

Policy instance

Insurance contract or identification number	5468140
Number of Individuals Covered	82
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,482
Total amount of fees paid to insurance company	USD $944
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	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL 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 Carrier	USD $32,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,063
Insurance broker organization code?	3
Amount paid for insurance broker fees	944
Additional information about fees paid to insurance broker	$893 PRODUCER BONUS PROGRAM PAYMENT AND $51 NON MONETARY COMPENSATION
Insurance broker name	JW TERRILL BENEFIT SERVICES INC

UNITED DENTAL CARE OF MISSOURI, INC. (National Association of Insurance Commissioners NAIC id number: 47044 )

Policy contract number

5468140

Policy instance

Insurance contract or identification number	5468140
Number of Individuals Covered	21
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $311
Total amount of fees paid to insurance company	USD $58
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	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $180
Insurance broker organization code?	3
Amount paid for insurance broker fees	58
Additional information about fees paid to insurance broker	PRODUCER BONUS PROGRAM PAYMENT
Insurance broker name	JW TERRILL BENEFIT SERVICES INC

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5468140

Policy instance

Insurance contract or identification number	5468140
Number of Individuals Covered	100
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $3,898
Total amount of fees paid to insurance company	USD $101
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $35,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,898
Amount paid for insurance broker fees	101
Additional information about fees paid to insurance broker	BROKER FEES
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

UNITED DENTAL CARE OF MISSOURI, INC. (National Association of Insurance Commissioners NAIC id number: 47044 )

Policy contract number

5468140

Policy instance

Insurance contract or identification number	5468140
Number of Individuals Covered	24
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $344
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $344
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

SE3R1357

Policy instance

Insurance contract or identification number	SE3R1357
Number of Individuals Covered	71
Insurance policy start date	2014-04-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $4,046
Welfare Benefit Premiums Paid to Carrier	USD $26,970
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,506
Insurance broker organization code?	3
Insurance broker name	BAS

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

TANW2002

Policy instance

Insurance contract or identification number	TANW2002
Number of Individuals Covered	71
Insurance policy start date	2014-07-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $15,414
Welfare Benefit Premiums Paid to Carrier	USD $102,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,358
Insurance broker organization code?	3
Insurance broker name	BAS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10143403

Policy instance

Insurance contract or identification number	10143403
Number of Individuals Covered	95
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $1,804
Total amount of fees paid to insurance company	USD $312
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,804
Amount paid for insurance broker fees	312
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10143404

Policy instance

Insurance contract or identification number	10143404
Number of Individuals Covered	95
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $3,752
Total amount of fees paid to insurance company	USD $589
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,752
Amount paid for insurance broker fees	589
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

949-6151,7954

Policy instance

Insurance contract or identification number	949-6151,7954
Number of Individuals Covered	71
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $1,212
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,212
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

949-3477

Policy instance

Insurance contract or identification number	949-3477
Number of Individuals Covered	67
Insurance policy start date	2013-04-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $921
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $921
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10143404

Policy instance

Insurance contract or identification number	10143404
Number of Individuals Covered	111
Insurance policy start date	2013-04-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $3,634
Total amount of fees paid to insurance company	USD $506
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,171
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,634
Amount paid for insurance broker fees	506
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10143403

Policy instance

Insurance contract or identification number	10143403
Number of Individuals Covered	111
Insurance policy start date	2013-04-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $1,924
Total amount of fees paid to insurance company	USD $267
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,924
Amount paid for insurance broker fees	267
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )

Policy contract number

GL/GF 11468

Policy instance

Insurance contract or identification number	GL/GF 11468
Number of Individuals Covered	67
Insurance policy start date	2012-06-01
Insurance policy end date	2013-05-31
Total amount of commissions paid to insurance broker	USD $964
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $8,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $964
Insurance broker organization code?	3
Insurance broker name	GEORGE J. MEUSCHKE AGENCY

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

SE3R1357

Policy instance

Insurance contract or identification number	SE3R1357
Number of Individuals Covered	63
Insurance policy start date	2013-04-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $15,554
Welfare Benefit Premiums Paid to Carrier	USD $103,690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,480
Insurance broker organization code?	3
Insurance broker name	BAS

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

DG63

Policy instance

Insurance contract or identification number	DG63
Number of Individuals Covered	45
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITED DENTAL CARE OF MISSOURI, INC. (National Association of Insurance Commissioners NAIC id number: 47044 )

Policy contract number

DG63

Policy instance

Insurance contract or identification number	DG63
Number of Individuals Covered	28
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $327
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $327
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00450608

Policy instance

Insurance contract or identification number	00450608
Number of Individuals Covered	42
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $1,011
Total amount of fees paid to insurance company	USD $515
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10
Insurance broker organization code?	3
Amount paid for insurance broker fees	515
Additional information about fees paid to insurance broker	BROKER FEES
Insurance broker name	ROBERT E. MILLER INSURANCE

UNITED DENTAL CARE OF MISSOURI, INC. (National Association of Insurance Commissioners NAIC id number: 47044 )

Policy contract number

DG63

Policy instance

Insurance contract or identification number	DG63
Number of Individuals Covered	28
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $281
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $281
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

DG63

Policy instance

Insurance contract or identification number	DG63
Number of Individuals Covered	27
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STARR GLOBAL A&H AND FEDERAL INSURANCE (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

SE3R1312

Policy instance

Insurance contract or identification number	SE3R1312
Number of Individuals Covered	60
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $14,038
Welfare Benefit Premiums Paid to Carrier	USD $93,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $936
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER GROUP

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )

Policy contract number

GL/GF 11468

Policy instance

Insurance contract or identification number	GL/GF 11468
Number of Individuals Covered	72
Insurance policy start date	2011-06-01
Insurance policy end date	2012-05-31
Total amount of commissions paid to insurance broker	USD $1,042
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	OTHER (SPECIFY)
Welfare Benefit Premiums Paid to Carrier	USD $9,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,042
Insurance broker organization code?	3
Insurance broker name	GEORGE J. MEUSCHKE AGENCY

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10143403

Policy instance

Insurance contract or identification number	10143403
Number of Individuals Covered	105
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $1,893
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,893
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00450608

Policy instance

Insurance contract or identification number	00450608
Number of Individuals Covered	37
Insurance policy start date	2011-08-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $775
Total amount of fees paid to insurance company	USD $168
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,673
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
Insurance broker organization code?	3
Amount paid for insurance broker fees	168
Additional information about fees paid to insurance broker	BROKER FEES
Insurance broker name	ROBERT E. MILLER INSURANCE

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10143404

Policy instance

Insurance contract or identification number	10143404
Number of Individuals Covered	105
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $3,564
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,564
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MILLER INSURANCE AGENCY

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

DG63

Policy instance

Insurance contract or identification number	DG63
Number of Individuals Covered	29
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STARR GLOBAL A&H AND FEDERAL INSURANCE (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

9960-5537-02

Policy instance

Insurance contract or identification number	9960-5537-02
Number of Individuals Covered	60
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $15,449
Welfare Benefit Premiums Paid to Carrier	USD $102,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITED DENTAL CARE OF MISSOURI, INC. (National Association of Insurance Commissioners NAIC id number: 47044 )

Policy contract number

DG63

Policy instance

Insurance contract or identification number	DG63
Number of Individuals Covered	20
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $195
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00450608

Policy instance

Insurance contract or identification number	00450608
Number of Individuals Covered	39
Insurance policy start date	2010-08-01
Insurance policy end date	2011-07-31
Total amount of commissions paid to insurance broker	USD $657
Total amount of fees paid to insurance company	USD $214
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )

Policy contract number

GLGF 11468

Policy instance

Insurance contract or identification number	GLGF 11468
Number of Individuals Covered	87
Insurance policy start date	2010-06-01
Insurance policy end date	2011-05-31
Total amount of commissions paid to insurance broker	USD $1,248
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $11,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

DG63

Policy instance

Insurance contract or identification number	DG63
Number of Individuals Covered	26
Insurance policy start date	2009-07-01
Insurance policy end date	2010-06-30
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STARR GLOBAL A&H AND FEDERAL INSURANCE (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

9960-5537-02

Policy instance

Insurance contract or identification number	9960-5537-02
Number of Individuals Covered	67
Insurance policy start date	2009-07-01
Insurance policy end date	2010-06-30
Total amount of commissions paid to insurance broker	USD $21,115
Welfare Benefit Premiums Paid to Carrier	USD $70,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITED DENTAL CARE OF MISSOURI, INC. (National Association of Insurance Commissioners NAIC id number: 47044 )

Policy contract number

DG63

Policy instance

Insurance contract or identification number	DG63
Number of Individuals Covered	36
Insurance policy start date	2009-07-01
Insurance policy end date	2010-06-30
Total amount of commissions paid to insurance broker	USD $373
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00450608

Policy instance

Insurance contract or identification number	00450608
Number of Individuals Covered	33
Insurance policy start date	2009-08-01
Insurance policy end date	2010-07-31
Total amount of commissions paid to insurance broker	USD $663
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )

Policy contract number

GLGF 11468

Policy instance

Insurance contract or identification number	GLGF 11468
Number of Individuals Covered	95
Insurance policy start date	2009-06-01
Insurance policy end date	2010-03-31
Total amount of commissions paid to insurance broker	USD $1,325
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
Other welfare benefits provided	ACCIDENTAL 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 Carrier	USD $12,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $125
Insurance broker organization code?	3
Insurance broker name	DIANN SULLIVAN

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

P70401

Policy instance

Insurance contract or identification number	P70401
Number of Individuals Covered	110
Insurance policy start date	2009-04-01
Insurance policy end date	2009-05-31
Total amount of commissions paid to insurance broker	USD $390
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 $2,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $390
Insurance broker organization code?	3
Insurance broker name	MARC F ANDERSON

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	BUTTERFIELD YOUTH SERVICES, INC.
Employer identification number (EIN):	440668473
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities