KUPPER CHEVROLET, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan KUPPER CHEVROLET INC BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2020: KUPPER CHEVROLET INC BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-05-01 | 303 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 0 |
| Total of all active and inactive participants | 2020-05-01 | 0 |
| 2019: KUPPER CHEVROLET INC BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-05-01 | 310 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 303 |
| Total of all active and inactive participants | 2019-05-01 | 303 |
| 2018: KUPPER CHEVROLET INC BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-05-01 | 187 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 310 |
| Total of all active and inactive participants | 2018-05-01 | 310 |
| 2017: KUPPER CHEVROLET INC BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-05-01 | 221 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 187 |
| Total of all active and inactive participants | 2017-05-01 | 187 |
| 2016: KUPPER CHEVROLET INC BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-05-01 | 158 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 221 |
| Total of all active and inactive participants | 2016-05-01 | 221 |
| 2015: KUPPER CHEVROLET INC BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 199 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 158 |
| Total of all active and inactive participants | 2015-05-01 | 158 |
| 2014: KUPPER CHEVROLET INC BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 190 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 199 |
| Total of all active and inactive participants | 2014-05-01 | 199 |
| 2013: KUPPER CHEVROLET INC BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 151 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 190 |
| Total of all active and inactive participants | 2013-05-01 | 190 |
| 2012: KUPPER CHEVROLET INC BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 167 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 151 |
| Total of all active and inactive participants | 2012-05-01 | 151 |
| 2011: KUPPER CHEVROLET INC BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-05-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 167 |
| Total of all active and inactive participants | 2011-05-01 | 167 |
| 2010: KUPPER CHEVROLET INC BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-05-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 131 |
| Total of all active and inactive participants | 2010-05-01 | 131 |
| 2009: KUPPER CHEVROLET INC BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-05-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 131 |
| Total of all active and inactive participants | 2009-05-01 | 131 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 5 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $471 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $5,958 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $429 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 4 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $428 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $373 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) |
| Policy contract number | 252487 |
| Policy instance | 2 |
| Insurance contract or identification number | 252487 | | Number of Individuals Covered | 139 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2020-06-03 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 6 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $235 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CRITICALL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $5,421 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $207 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 7 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $232 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,859 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $226 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 8 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $658 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,101 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $516 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30066783 |
| Policy instance | 3 |
| Insurance contract or identification number | 30066783 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $112 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,134 | | 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 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) |
| Policy contract number | 252487 |
| Policy instance | 1 |
| Insurance contract or identification number | 252487 | | Number of Individuals Covered | 168 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,079 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) |
| Policy contract number | 252487 |
| Policy instance | 2 |
| Insurance contract or identification number | 252487 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30066783 |
| Policy instance | 3 |
| Insurance contract or identification number | 30066783 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $455 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,073 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $455 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 4 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $1,614 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,727 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,541 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 6 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $1,084 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CRITICALL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $9,614 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,012 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 7 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $1,131 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,068 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,117 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) |
| Policy contract number | 252487 |
| Policy instance | 1 |
| Insurance contract or identification number | 252487 | | Number of Individuals Covered | 303 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $253,935 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 5 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $1,416 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $18,802 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,377 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 8 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 59 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $3,374 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,181 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,030 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05333530 |
| Policy instance | 1 |
| Insurance contract or identification number | TS05333530 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $3,118 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $103,802 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,795 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30066783 |
| Policy instance | 2 |
| Insurance contract or identification number | 30066783 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $458 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,685 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $458 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) |
| Policy contract number | 252487 |
| Policy instance | 3 |
| Insurance contract or identification number | 252487 | | Number of Individuals Covered | 310 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $177,110 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 4 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $1,923 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,310 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,923 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 5 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $1,892 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $20,498 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,892 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 6 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $562 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $10,186 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $562 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 7 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $1,243 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,791 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,243 | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | G1036 |
| Policy instance | 8 |
| Insurance contract or identification number | G1036 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $3,080 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,474 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,080 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) |
| Policy contract number | 68652+ |
| Policy instance | 3 |
| Insurance contract or identification number | 68652+ | | Number of Individuals Covered | 187 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $23,643 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $147,366 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,643 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY INSURANCE |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30066783 |
| Policy instance | 2 |
| Insurance contract or identification number | 30066783 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $870 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,488 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $435 | | Insurance broker organization code? | 3 | | Insurance broker name | JESSICA FRINK |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05333530 |
| Policy instance | 1 |
| Insurance contract or identification number | TS05333530 | | Number of Individuals Covered | 240 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $2,827 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $85,729 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,827 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY INSURANCE |
|
| MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 ) |
| Policy contract number | 142603 |
| Policy instance | 1 |
| Insurance contract or identification number | 142603 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $32,418 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,150,670 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,418 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY - PATRICK THOMAS |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05333530 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05333530 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $2,873 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $89,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,873 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY |
|
| MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 ) |
| Policy contract number | 142603 |
| Policy instance | 1 |
| Insurance contract or identification number | 142603 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $23,166 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,109,265 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,166 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY - PATRICK THOMAS |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05333530 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05333530 | | Number of Individuals Covered | 199 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $2,884 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,972 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,884 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY |
|
| MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 ) |
| Policy contract number | 142603 |
| Policy instance | 1 |
| Insurance contract or identification number | 142603 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $11,072 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $914,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,072 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY, PATRICK THOMAS |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05333530 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05333530 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $2,726 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $74,085 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,726 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05333530 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05333530 | | Number of Individuals Covered | 151 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,085 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,705 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,085 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY |
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| MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 ) |
| Policy contract number | 142603 |
| Policy instance | 1 |
| Insurance contract or identification number | 142603 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $8,300 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $547,388 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,300 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY, PATRICK THOMAS |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05333530 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05333530 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $2,994 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $54,075 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 ) |
| Policy contract number | 142603 |
| Policy instance | 1 |
| Insurance contract or identification number | 142603 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $8,619 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $505,038 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| MEDICA (National Association of Insurance Commissioners NAIC id number: 12459 ) |
| Policy contract number | 142603 |
| Policy instance | 1 |
| Insurance contract or identification number | 142603 | | Number of Individuals Covered | 84 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $7,356 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $473,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,356 | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY, PATRICK THOMAS |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05333530 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05333530 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $2,404 | | Total amount of fees paid to insurance company | USD $67 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,052 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,404 | | Amount paid for insurance broker fees | 67 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | WARNER AND COMPANY |
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