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COIL TUBING SOLUTIONS LLC 401k Plan overview

Plan NameCOIL TUBING SOLUTIONS LLC
Plan identification number 501

COIL TUBING SOLUTIONS LLC Benefits

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

401k Sponsoring company profile

COIL TUBING PARTNERS LLC has sponsored the creation of one or more 401k plans.

Company Name:COIL TUBING PARTNERS LLC
Employer identification number (EIN):455258418
NAIC Classification:211120
NAIC Description:Crude Petroleum Extraction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COIL TUBING SOLUTIONS LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-02-01
5012021-02-01
5012020-02-01
5012019-02-01
5012018-02-01
5012017-02-01JORDAN PERRET
5012016-02-01JORDAN PERRET
5012015-02-01JORDAN PERRET
5012014-02-01GLEN J RITTER

Plan Statistics for COIL TUBING SOLUTIONS LLC

401k plan membership statisitcs for COIL TUBING SOLUTIONS LLC

Measure Date Value
2022: COIL TUBING SOLUTIONS LLC 2022 401k membership
Total participants, beginning-of-year2022-02-01295
Total number of active participants reported on line 7a of the Form 55002022-02-01344
Number of retired or separated participants receiving benefits2022-02-010
Number of other retired or separated participants entitled to future benefits2022-02-010
Total of all active and inactive participants2022-02-01344
2021: COIL TUBING SOLUTIONS LLC 2021 401k membership
Total participants, beginning-of-year2021-02-01239
Total number of active participants reported on line 7a of the Form 55002021-02-01295
Number of retired or separated participants receiving benefits2021-02-010
Number of other retired or separated participants entitled to future benefits2021-02-010
Total of all active and inactive participants2021-02-01295
2020: COIL TUBING SOLUTIONS LLC 2020 401k membership
Total participants, beginning-of-year2020-02-01439
Total number of active participants reported on line 7a of the Form 55002020-02-01239
Number of retired or separated participants receiving benefits2020-02-010
Number of other retired or separated participants entitled to future benefits2020-02-010
Total of all active and inactive participants2020-02-01239
2019: COIL TUBING SOLUTIONS LLC 2019 401k membership
Total participants, beginning-of-year2019-02-01384
Total number of active participants reported on line 7a of the Form 55002019-02-01439
Number of retired or separated participants receiving benefits2019-02-010
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-01439
2018: COIL TUBING SOLUTIONS LLC 2018 401k membership
Total participants, beginning-of-year2018-02-01295
Total number of active participants reported on line 7a of the Form 55002018-02-01384
Number of retired or separated participants receiving benefits2018-02-010
Number of other retired or separated participants entitled to future benefits2018-02-010
Total of all active and inactive participants2018-02-01384
2017: COIL TUBING SOLUTIONS LLC 2017 401k membership
Total participants, beginning-of-year2017-02-01225
Total number of active participants reported on line 7a of the Form 55002017-02-01295
Number of retired or separated participants receiving benefits2017-02-010
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-01295
2016: COIL TUBING SOLUTIONS LLC 2016 401k membership
Total participants, beginning-of-year2016-02-01591
Total number of active participants reported on line 7a of the Form 55002016-02-01225
Number of retired or separated participants receiving benefits2016-02-010
Number of other retired or separated participants entitled to future benefits2016-02-010
Total of all active and inactive participants2016-02-01225
2015: COIL TUBING SOLUTIONS LLC 2015 401k membership
Total participants, beginning-of-year2015-02-01227
Total number of active participants reported on line 7a of the Form 55002015-02-01591
Number of retired or separated participants receiving benefits2015-02-010
Number of other retired or separated participants entitled to future benefits2015-02-010
Total of all active and inactive participants2015-02-01591
2014: COIL TUBING SOLUTIONS LLC 2014 401k membership
Total participants, beginning-of-year2014-02-01131
Total number of active participants reported on line 7a of the Form 55002014-02-01227
Number of retired or separated participants receiving benefits2014-02-010
Number of other retired or separated participants entitled to future benefits2014-02-010
Total of all active and inactive participants2014-02-01227

Form 5500 Responses for COIL TUBING SOLUTIONS LLC

2022: COIL TUBING SOLUTIONS LLC 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Plan funding arrangement – InsuranceYes
2022-02-01Plan funding arrangement – General assets of the sponsorYes
2022-02-01Plan benefit arrangement – InsuranceYes
2021: COIL TUBING SOLUTIONS LLC 2021 form 5500 responses
2021-02-01Type of plan entitySingle employer plan
2021-02-01Plan funding arrangement – InsuranceYes
2021-02-01Plan funding arrangement – General assets of the sponsorYes
2021-02-01Plan benefit arrangement – InsuranceYes
2020: COIL TUBING SOLUTIONS LLC 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Plan funding arrangement – General assets of the sponsorYes
2020-02-01Plan benefit arrangement – InsuranceYes
2019: COIL TUBING SOLUTIONS LLC 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Plan funding arrangement – General assets of the sponsorYes
2019-02-01Plan benefit arrangement – InsuranceYes
2018: COIL TUBING SOLUTIONS LLC 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Plan funding arrangement – General assets of the sponsorYes
2018-02-01Plan benefit arrangement – InsuranceYes
2017: COIL TUBING SOLUTIONS LLC 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Plan funding arrangement – General assets of the sponsorYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: COIL TUBING SOLUTIONS LLC 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Plan funding arrangement – General assets of the sponsorYes
2016-02-01Plan benefit arrangement – InsuranceYes
2015: COIL TUBING SOLUTIONS LLC 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Plan funding arrangement – General assets of the sponsorYes
2015-02-01Plan benefit arrangement – InsuranceYes
2014: COIL TUBING SOLUTIONS LLC 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01First time form 5500 has been submittedYes
2014-02-01Plan funding arrangement – General assets of the sponsorYes
2014-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number167137
Policy instance 3
Insurance contract or identification number167137
Number of Individuals Covered354
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $32,935
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,470
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number28S44ERC
Policy instance 2
Insurance contract or identification number28S44ERC
Number of Individuals Covered340
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $129,459
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $119,524
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00524312
Policy instance 1
Insurance contract or identification number00524312
Number of Individuals Covered344
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $10,714
Total amount of fees paid to insurance companyUSD $4,777
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,714
Amount paid for insurance broker fees1534
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number167137
Policy instance 3
Insurance contract or identification number167137
Number of Individuals Covered283
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $17,161
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,161
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number28S44ERC
Policy instance 2
Insurance contract or identification number28S44ERC
Number of Individuals Covered292
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $112,606
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $112,606
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00524312
Policy instance 1
Insurance contract or identification number00524312
Number of Individuals Covered295
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $9,062
Total amount of fees paid to insurance companyUSD $1,500
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $90,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,062
Amount paid for insurance broker fees1500
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00524312
Policy instance 1
Insurance contract or identification number00524312
Number of Individuals Covered240
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $8,009
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,009
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number28S44ERC
Policy instance 2
Insurance contract or identification number28S44ERC
Number of Individuals Covered239
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $93,075
Total amount of fees paid to insurance companyUSD $54,556
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $93,075
Amount paid for insurance broker fees54556
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number167137
Policy instance 3
Insurance contract or identification number167137
Number of Individuals Covered238
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $15,121
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,121
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF020346
Policy instance 3
Insurance contract or identification numberF020346
Number of Individuals Covered436
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $34,042
Total amount of fees paid to insurance companyUSD $6,573
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT-TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $272,178
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,042
Amount paid for insurance broker fees6573
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number28S44ERC
Policy instance 2
Insurance contract or identification number28S44ERC
Number of Individuals Covered439
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $154,116
Total amount of fees paid to insurance companyUSD $33,063
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $154,116
Amount paid for insurance broker fees33063
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00524312
Policy instance 1
Insurance contract or identification number00524312
Number of Individuals Covered383
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $48,322
Total amount of fees paid to insurance companyUSD $6,110
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $483,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,322
Amount paid for insurance broker fees6110
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF020346
Policy instance 3
Insurance contract or identification numberF020346
Number of Individuals Covered382
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $26,477
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $209,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,477
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number28S44ERC
Policy instance 2
Insurance contract or identification number28S44ERC
Number of Individuals Covered1212
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $130,253
Total amount of fees paid to insurance companyUSD $23,363
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $120,860
Amount paid for insurance broker fees23363
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00524312
Policy instance 1
Insurance contract or identification number00524312
Number of Individuals Covered383
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $36,801
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $368,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,801
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF020346
Policy instance 3
Insurance contract or identification numberF020346
Number of Individuals Covered304
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $20,981
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $163,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,954
Insurance broker nameMCGRIFF, SEIBELS & WILLIAMS
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number28S44ERC
Policy instance 2
Insurance contract or identification number28S44ERC
Number of Individuals Covered930
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $81,167
Total amount of fees paid to insurance companyUSD $45,740
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,167
Amount paid for insurance broker fees45740
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameDWIGHT W ANDRUS INS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00524312
Policy instance 1
Insurance contract or identification number00524312
Number of Individuals Covered295
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $25,897
Total amount of fees paid to insurance companyUSD $3,252
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $258,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,897
Amount paid for insurance broker fees3252
Insurance broker nameDWIGHT ANDRUS INSURANCE AGY
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05925630
Policy instance 1
Insurance contract or identification numberKM05925630
Number of Individuals Covered591
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $4,581
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,581
Insurance broker nameDWIGHT W ANDRUS INSURANCE
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number28S44ERC
Policy instance 2
Insurance contract or identification number28S44ERC
Number of Individuals Covered706
Insurance policy start date2015-02-01
Insurance policy end date2016-02-01
Total amount of commissions paid to insurance brokerUSD $62,806
Total amount of fees paid to insurance companyUSD $51,709
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $62,806
Amount paid for insurance broker fees51709
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameDWIGHT W ANDRUS INS INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number234473
Policy instance 3
Insurance contract or identification number234473
Number of Individuals Covered226
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $43,873
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $324,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,873
Insurance broker organization code?3
Insurance broker nameDWIGHT W ANDRUS INS INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number234473
Policy instance 3
Insurance contract or identification number234473
Number of Individuals Covered227
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $38,914
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $233,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,914
Insurance broker organization code?3
Insurance broker nameDWIGHT W ANDRUS INS INC
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number28S44ERC
Policy instance 2
Insurance contract or identification number28S44ERC
Number of Individuals Covered213
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $3,040
Total amount of fees paid to insurance companyUSD $227
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,040
Amount paid for insurance broker fees227
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameDWIGHT W ANDRUS INS INC
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number28S44ERC
Policy instance 1
Insurance contract or identification number28S44ERC
Number of Individuals Covered222
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $96,317
Total amount of fees paid to insurance companyUSD $31,547
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,635,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $96,317
Amount paid for insurance broker fees31547
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameDWIGHT W ANDRUS INS INC

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