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BANKWEST EMPLOYEE BENEFIT PROGRAM 401k Plan overview

Plan NameBANKWEST EMPLOYEE BENEFIT PROGRAM
Plan identification number 501

BANKWEST EMPLOYEE BENEFIT PROGRAM Benefits

401k Plan TypeWelfare 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)

401k Sponsoring company profile

BANKWEST, INC. has sponsored the creation of one or more 401k plans.

Company Name:BANKWEST, INC.
Employer identification number (EIN):460177475
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BANKWEST EMPLOYEE BENEFIT PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01OLIVIA CONRAD
5012016-01-01OLIVIA CONRAD
5012015-01-01OLIVIA CONRAD
5012014-01-01
5012013-01-01
5012012-01-01KAILENE FREY
5012011-01-01KAILENE FREY
5012010-01-01CHERYL STONE
5012009-01-01CHERYL STONE

Plan Statistics for BANKWEST EMPLOYEE BENEFIT PROGRAM

401k plan membership statisitcs for BANKWEST EMPLOYEE BENEFIT PROGRAM

Measure Date Value
2022: BANKWEST EMPLOYEE BENEFIT PROGRAM 2022 401k membership
Total participants, beginning-of-year2022-01-01315
Total number of active participants reported on line 7a of the Form 55002022-01-01333
Number of retired or separated participants receiving benefits2022-01-017
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01340
2021: BANKWEST EMPLOYEE BENEFIT PROGRAM 2021 401k membership
Total participants, beginning-of-year2021-01-01301
Total number of active participants reported on line 7a of the Form 55002021-01-01315
Number of retired or separated participants receiving benefits2021-01-017
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01322
2020: BANKWEST EMPLOYEE BENEFIT PROGRAM 2020 401k membership
Total participants, beginning-of-year2020-01-01290
Total number of active participants reported on line 7a of the Form 55002020-01-01301
Number of retired or separated participants receiving benefits2020-01-017
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01308
2019: BANKWEST EMPLOYEE BENEFIT PROGRAM 2019 401k membership
Total participants, beginning-of-year2019-01-01277
Total number of active participants reported on line 7a of the Form 55002019-01-01290
Number of retired or separated participants receiving benefits2019-01-018
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01298
2018: BANKWEST EMPLOYEE BENEFIT PROGRAM 2018 401k membership
Total participants, beginning-of-year2018-01-01293
Total number of active participants reported on line 7a of the Form 55002018-01-01277
Number of retired or separated participants receiving benefits2018-01-0110
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01287
2017: BANKWEST EMPLOYEE BENEFIT PROGRAM 2017 401k membership
Total participants, beginning-of-year2017-01-01282
Total number of active participants reported on line 7a of the Form 55002017-01-01293
Number of retired or separated participants receiving benefits2017-01-0118
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01311
2016: BANKWEST EMPLOYEE BENEFIT PROGRAM 2016 401k membership
Total participants, beginning-of-year2016-01-01256
Total number of active participants reported on line 7a of the Form 55002016-01-01282
Number of retired or separated participants receiving benefits2016-01-0115
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01297
2015: BANKWEST EMPLOYEE BENEFIT PROGRAM 2015 401k membership
Total participants, beginning-of-year2015-01-01250
Total number of active participants reported on line 7a of the Form 55002015-01-01256
Number of retired or separated participants receiving benefits2015-01-0110
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01266
2014: BANKWEST EMPLOYEE BENEFIT PROGRAM 2014 401k membership
Total participants, beginning-of-year2014-01-01255
Total number of active participants reported on line 7a of the Form 55002014-01-01239
Number of retired or separated participants receiving benefits2014-01-0111
Total of all active and inactive participants2014-01-01250
2013: BANKWEST EMPLOYEE BENEFIT PROGRAM 2013 401k membership
Total participants, beginning-of-year2013-01-01235
Total number of active participants reported on line 7a of the Form 55002013-01-01240
Number of retired or separated participants receiving benefits2013-01-0115
Total of all active and inactive participants2013-01-01255
2012: BANKWEST EMPLOYEE BENEFIT PROGRAM 2012 401k membership
Total participants, beginning-of-year2012-01-01228
Total number of active participants reported on line 7a of the Form 55002012-01-01223
Number of retired or separated participants receiving benefits2012-01-0112
Total of all active and inactive participants2012-01-01235
2011: BANKWEST EMPLOYEE BENEFIT PROGRAM 2011 401k membership
Total participants, beginning-of-year2011-01-01232
Total number of active participants reported on line 7a of the Form 55002011-01-01207
Number of retired or separated participants receiving benefits2011-01-0121
Total of all active and inactive participants2011-01-01228
2010: BANKWEST EMPLOYEE BENEFIT PROGRAM 2010 401k membership
Total participants, beginning-of-year2010-01-01246
Total number of active participants reported on line 7a of the Form 55002010-01-01212
Number of retired or separated participants receiving benefits2010-01-0120
Total of all active and inactive participants2010-01-01232
2009: BANKWEST EMPLOYEE BENEFIT PROGRAM 2009 401k membership
Total participants, beginning-of-year2009-01-01258
Total number of active participants reported on line 7a of the Form 55002009-01-01225
Number of retired or separated participants receiving benefits2009-01-0121
Total of all active and inactive participants2009-01-01246

Form 5500 Responses for BANKWEST EMPLOYEE BENEFIT PROGRAM

2022: BANKWEST EMPLOYEE BENEFIT PROGRAM 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: BANKWEST EMPLOYEE BENEFIT PROGRAM 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: BANKWEST EMPLOYEE BENEFIT PROGRAM 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: BANKWEST EMPLOYEE BENEFIT PROGRAM 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: BANKWEST EMPLOYEE BENEFIT PROGRAM 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: BANKWEST EMPLOYEE BENEFIT PROGRAM 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: BANKWEST EMPLOYEE BENEFIT PROGRAM 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: BANKWEST EMPLOYEE BENEFIT PROGRAM 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: BANKWEST EMPLOYEE BENEFIT PROGRAM 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: BANKWEST EMPLOYEE BENEFIT PROGRAM 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: BANKWEST EMPLOYEE BENEFIT PROGRAM 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: BANKWEST EMPLOYEE BENEFIT PROGRAM 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: BANKWEST EMPLOYEE BENEFIT PROGRAM 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: BANKWEST EMPLOYEE BENEFIT PROGRAM 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 )
Policy contract numberA26
Policy instance 6
Insurance contract or identification numberA26
Number of Individuals Covered291
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $30,573
Total amount of fees paid to insurance companyUSD $181,556
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,483,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,573
Amount paid for insurance broker fees181556
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9261549474
Policy instance 5
Insurance contract or identification number9261549474
Number of Individuals Covered350
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $38,091
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $141,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,269
Insurance broker organization code?5
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered154
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,609
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,988
Insurance broker organization code?5
DAKOTACARE ADMINISTRATIVE SERVICES (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberERLL12100671001
Policy instance 3
Insurance contract or identification numberERLL12100671001
Number of Individuals Covered282
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?5
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered282
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,497
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,497
Insurance broker organization code?3
OPTILEGRA INC (National Association of Insurance Commissioners NAIC id number: 16413 )
Policy contract number1679
Policy instance 1
Insurance contract or identification number1679
Number of Individuals Covered333
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,853
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,853
Insurance broker organization code?3
OPTILEGRA INC (National Association of Insurance Commissioners NAIC id number: 16413 )
Policy contract number1679
Policy instance 1
Insurance contract or identification number1679
Number of Individuals Covered315
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,333
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,333
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered275
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $3,836
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,836
Insurance broker organization code?3
DAKOTACARE ADMINISTRATIVE SERVICES (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberERLL12100671001
Policy instance 3
Insurance contract or identification numberERLL12100671001
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?5
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered132
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,519
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,742
Insurance broker organization code?5
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9261549474
Policy instance 5
Insurance contract or identification number9261549474
Number of Individuals Covered328
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $40,794
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $151,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,772
Insurance broker organization code?5
WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 )
Policy contract numberA26
Policy instance 6
Insurance contract or identification numberA26
Number of Individuals Covered276
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $29,583
Total amount of fees paid to insurance companyUSD $171,102
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,702,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,583
Amount paid for insurance broker fees171102
Insurance broker organization code?3
OPTILEGRA INC (National Association of Insurance Commissioners NAIC id number: 16413 )
Policy contract number1679
Policy instance 1
Insurance contract or identification number1679
Number of Individuals Covered301
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,981
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,981
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered271
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $4,332
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,332
Insurance broker organization code?3
DAKOTACARE ADMINISTRATIVE SERVICES (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberERLL12100671001
Policy instance 3
Insurance contract or identification numberERLL12100671001
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?5
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered114
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,710
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,081
Insurance broker organization code?5
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9261549474
Policy instance 5
Insurance contract or identification number9261549474
Number of Individuals Covered319
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $39,092
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $176,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,437
Insurance broker organization code?5
WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 )
Policy contract numberA26
Policy instance 6
Insurance contract or identification numberA26
Number of Individuals Covered267
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $28,188
Total amount of fees paid to insurance companyUSD $156,475
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,306,577
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,188
Amount paid for insurance broker fees156475
Insurance broker organization code?3
OPTILEGRA INC (National Association of Insurance Commissioners NAIC id number: 16413 )
Policy contract number1679
Policy instance 1
Insurance contract or identification number1679
Number of Individuals Covered290
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,937
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,937
Insurance broker organization code?3
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberERLL12100671001
Policy instance 3
Insurance contract or identification numberERLL12100671001
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?5
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered262
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $3,330
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,330
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered94
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,264
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,835
Insurance broker organization code?5
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9261549474
Policy instance 5
Insurance contract or identification number9261549474
Number of Individuals Covered309
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $31,984
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $130,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,378
Insurance broker organization code?5
WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 )
Policy contract numberA26
Policy instance 6
Insurance contract or identification numberA26
Number of Individuals Covered258
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $27,828
Total amount of fees paid to insurance companyUSD $148,821
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,236,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,828
Amount paid for insurance broker fees148821
Insurance broker organization code?3
WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 )
Policy contract numberA26
Policy instance 6
Insurance contract or identification numberA26
Number of Individuals Covered257
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $46,185
Total amount of fees paid to insurance companyUSD $137,640
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,284,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,185
Amount paid for insurance broker fees137640
Insurance broker organization code?3
Insurance broker nameFISCHER ROUNDS & ASSOC
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9261549474
Policy instance 5
Insurance contract or identification number9261549474
Number of Individuals Covered309
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $30,954
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $125,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,662
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered83
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $9,287
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,530
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberERLL12100671001
Policy instance 3
Insurance contract or identification numberERLL12100671001
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $54
Total amount of fees paid to insurance companyUSD $1,200
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54
Amount paid for insurance broker fees1200
Insurance broker organization code?5
Insurance broker nameDAKOTACARE ADMINISTRATIVE SERVICES
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered241
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $3,825
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,825
Insurance broker organization code?3
Insurance broker nameBANKWEST INC DBA BANKWEST INSURANCE
OPTILEGRA INC (National Association of Insurance Commissioners NAIC id number: 16413 )
Policy contract number1679
Policy instance 1
Insurance contract or identification number1679
Number of Individuals Covered293
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,898
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,898
Insurance broker organization code?3
Insurance broker nameAZIZ ELMAMOUNI
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9261549474
Policy instance 5
Insurance contract or identification number9261549474
Number of Individuals Covered272
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $28,506
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $96,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,395
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberERLL12100671001
Policy instance 3
Insurance contract or identification numberERLL12100671001
Number of Individuals Covered535
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $87,553
Total amount of fees paid to insurance companyUSD $11,501
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $583,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,451
Amount paid for insurance broker fees11501
Insurance broker organization code?5
Insurance broker nameBOB CLARK INSURANCE INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered222
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $4,055
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,055
Insurance broker organization code?3
Insurance broker nameBANKWEST INC DBA BANKWEST INSURANCE
OPTILEGRA INC (National Association of Insurance Commissioners NAIC id number: 16413 )
Policy contract number1679
Policy instance 1
Insurance contract or identification number1679
Number of Individuals Covered256
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,937
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,937
Insurance broker organization code?3
Insurance broker nameAZIZ E MAMOUNI
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered75
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,656
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,195
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered69
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,535
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,166
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberUNI-200819
Policy instance 3
Insurance contract or identification numberUNI-200819
Number of Individuals Covered211
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $78,674
Total amount of fees paid to insurance companyUSD $10,451
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $524,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $72,855
Amount paid for insurance broker fees10451
Insurance broker organization code?5
Insurance broker nameBOB CLARK INSURANCE INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered204
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $3,552
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,552
Insurance broker organization code?3
Insurance broker nameBANKWEST INC DBA BANKWEST INSURANCE
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12107182
Policy instance 1
Insurance contract or identification number12107182
Number of Individuals Covered239
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $967
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $967
Insurance broker organization code?3
Insurance broker nameBOB CLARK INSURANCE INC
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9261549474
Policy instance 5
Insurance contract or identification number9261549474
Number of Individuals Covered244
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $26,509
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $98,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,546
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered59
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,230
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,886
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12107182
Policy instance 1
Insurance contract or identification number12107182
Number of Individuals Covered240
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $938
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,273
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $938
Insurance broker organization code?3
Insurance broker nameBOB CLARK INSURANCE INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered204
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $3,135
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,135
Insurance broker organization code?3
Insurance broker nameBANKWEST INC DBA BANKWEST INSURANCE
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberUNI-200819
Policy instance 3
Insurance contract or identification numberUNI-200819
Number of Individuals Covered211
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $70,330
Total amount of fees paid to insurance companyUSD $9,690
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $468,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64,723
Amount paid for insurance broker fees9690
Insurance broker organization code?5
Insurance broker nameBOB CLARK INSURANCE INC
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9261549474
Policy instance 5
Insurance contract or identification number9261549474
Number of Individuals Covered244
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $29,827
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $110,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,618
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered202
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $3,459
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,459
Insurance broker organization code?3
Insurance broker nameBANKWEST INC DBA BANKWEST INSURANCE
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberUNI-200819
Policy instance 3
Insurance contract or identification numberUNI-200819
Number of Individuals Covered201
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $60,587
Total amount of fees paid to insurance companyUSD $5,427
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $403,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,318
Amount paid for insurance broker fees5427
Insurance broker organization code?5
Insurance broker nameBOB CLARK INSURANCE INC
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered53
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,289
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,966
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9261549474
Policy instance 5
Insurance contract or identification number9261549474
Number of Individuals Covered233
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $18,270
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $80,701
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,656
Insurance broker organization code?5
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12107182
Policy instance 1
Insurance contract or identification number12107182
Number of Individuals Covered223
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $907
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $907
Insurance broker organization code?3
Insurance broker nameBOB CLARK INSURANCE INC
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9260548097
Policy instance 4
Insurance contract or identification number9260548097
Number of Individuals Covered54
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,430
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200819
Policy instance 3
Insurance contract or identification numberUNI-200819
Number of Individuals Covered191
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $60,886
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $405,906
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered201
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,511
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,384
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 number12107182
Policy instance 1
Insurance contract or identification number12107182
Number of Individuals Covered207
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $885
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number
Policy instance 4
Number of Individuals Covered225
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,744
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $86,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,744
Insurance broker organization code?3
Insurance broker nameSUMMIT REINSURANCE SERVICES INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD113260
Policy instance 2
Insurance contract or identification numberLTD113260
Number of Individuals Covered210
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,967
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,967
Insurance broker organization code?3
Insurance broker nameBANKWEST INC DBA BANKWEST INSURANCE
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200819
Policy instance 3
Insurance contract or identification numberUNI-200819
Number of Individuals Covered202
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $53,935
Total amount of fees paid to insurance companyUSD $-3
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $359,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,312
Amount paid for insurance broker fees-3
Insurance broker organization code?5
Insurance broker nameBOB CLARK INSURANCE INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12107182
Policy instance 1
Insurance contract or identification number12107182
Number of Individuals Covered212
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $887
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $887
Insurance broker organization code?3
Insurance broker nameBOB CLARK INSURANCE INC

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