SIOUX FALLS FORD INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SIOUX FALLS FORD DAKOTACARE FLEX PLAN
| Measure | Date | Value |
|---|
| 2022: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 311 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 328 |
| Total of all active and inactive participants | 2022-01-01 | 328 |
| 2021: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 307 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 309 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 2 |
| Total of all active and inactive participants | 2021-01-01 | 311 |
| 2020: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 301 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 297 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 1 |
| Total of all active and inactive participants | 2020-01-01 | 298 |
| 2019: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 286 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 2 |
| Total of all active and inactive participants | 2019-01-01 | 288 |
| 2018: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 206 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 227 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 3 |
| Total of all active and inactive participants | 2018-01-01 | 230 |
| 2017: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 208 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 199 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 2 |
| Total of all active and inactive participants | 2017-01-01 | 201 |
| 2016: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 194 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 202 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 3 |
| Total of all active and inactive participants | 2016-01-01 | 205 |
| 2015: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 179 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 181 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 4 |
| Total of all active and inactive participants | 2015-01-01 | 185 |
| 2014: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 181 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 178 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 1 |
| Total of all active and inactive participants | 2014-01-01 | 179 |
| 2013: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 146 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 159 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 1 |
| Total of all active and inactive participants | 2013-01-01 | 160 |
| 2012: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 117 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 117 |
| 2011: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 129 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 4 |
| Total of all active and inactive participants | 2011-01-01 | 133 |
| 2010: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 122 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 1 |
| Total of all active and inactive participants | 2010-01-01 | 123 |
| 2009: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 96 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 106 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 2 |
| Total of all active and inactive participants | 2009-01-01 | 108 |
| 2022: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: SIOUX FALLS FORD DAKOTACARE FLEX PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1120535 |
| Policy instance | 4 |
| Insurance contract or identification number | 1120535 | | Number of Individuals Covered | 317 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $13,894 | | Total amount of fees paid to insurance company | USD $725 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $125,371 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,877 | | Amount paid for insurance broker fees | 725 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 3 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 94 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $7,358 | | Total amount of fees paid to insurance company | USD $1,341 | | Welfare Benefit Premiums Paid to Carrier | USD $26,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,640 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1341 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 2 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 323 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $6,778 | | Total amount of fees paid to insurance company | USD $1,966 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,086 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,302 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1966 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 ) |
| Policy contract number | A0000565 |
| Policy instance | 1 |
| Insurance contract or identification number | A0000565 | | Number of Individuals Covered | 180 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 ) |
| Policy contract number | SD526 |
| Policy instance | 1 |
| Insurance contract or identification number | SD526 | | Number of Individuals Covered | 365 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 2 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $8,714 | | Total amount of fees paid to insurance company | USD $3,268 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $108,909 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,446 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3268 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 3 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 289 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,452 | | Total amount of fees paid to insurance company | USD $1,737 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $34,539 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,471 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1737 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 4 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,973 | | Total amount of fees paid to insurance company | USD $1,163 | | Welfare Benefit Premiums Paid to Carrier | USD $23,261 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,650 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1163 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1120535 |
| Policy instance | 5 |
| Insurance contract or identification number | 1120535 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,942 | | Total amount of fees paid to insurance company | USD $698 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,646 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,412 | | Amount paid for insurance broker fees | 349 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 ) |
| Policy contract number | SD526 |
| Policy instance | 1 |
| Insurance contract or identification number | SD526 | | Number of Individuals Covered | 360 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 2 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $8,658 | | Total amount of fees paid to insurance company | USD $2,857 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,295 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,765 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2857 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 3 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 279 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $5,004 | | Total amount of fees paid to insurance company | USD $1,395 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $27,731 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,788 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1395 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 4 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 62 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $5,052 | | Total amount of fees paid to insurance company | USD $918 | | Welfare Benefit Premiums Paid to Carrier | USD $18,347 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,667 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 918 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1120535 |
| Policy instance | 5 |
| Insurance contract or identification number | 1120535 | | Number of Individuals Covered | 239 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,713 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,579 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,246 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 5 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $3,689 | | Total amount of fees paid to insurance company | USD $593 | | Welfare Benefit Premiums Paid to Carrier | USD $11,858 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,370 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 593 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 4 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $5,697 | | Total amount of fees paid to insurance company | USD $1,502 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $29,852 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,001 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1502 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 165078 |
| Policy instance | 3 |
| Insurance contract or identification number | 165078 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $10,346 | | Total amount of fees paid to insurance company | USD $2,092 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $92,385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,766 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2092 | | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-040279 |
| Policy instance | 2 |
| Insurance contract or identification number | 010-040279 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,158 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,806 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,158 | | Insurance broker organization code? | 3 |
|
| AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 ) |
| Policy contract number | SD526 |
| Policy instance | 1 |
| Insurance contract or identification number | SD526 | | Number of Individuals Covered | 357 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 ) |
| Policy contract number | 2645 |
| Policy instance | 1 |
| Insurance contract or identification number | 2645 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,833 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $103,648 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,383 | | Insurance broker organization code? | 3 |
|
| AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 ) |
| Policy contract number | SD526 |
| Policy instance | 2 |
| Insurance contract or identification number | SD526 | | Number of Individuals Covered | 349 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $24,540 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,290 | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 3 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 209 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,625 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,264 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $896 | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 4 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 28 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $940 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CRITICAL ILLNESS COVERAGE | | Welfare Benefit Premiums Paid to Carrier | USD $2,561 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $396 | | Insurance broker organization code? | 3 |
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| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 5 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 33 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,797 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENT COVERAGE | | Welfare Benefit Premiums Paid to Carrier | USD $5,477 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $831 | | Insurance broker organization code? | 3 |
|
| LEADERS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 74799 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 6 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 24 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,288 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,892 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,509 | | Insurance broker organization code? | 3 |
|
| LEADERS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 74799 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 7 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 324 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $781 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,458 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $359 | | Insurance broker organization code? | 3 |
|
| LEADERS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 74799 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 8 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 108 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,914 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,144 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,494 | | Insurance broker organization code? | 3 |
|
| AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 ) |
| Policy contract number | SD526 |
| Policy instance | 2 |
| Insurance contract or identification number | SD526 | | Number of Individuals Covered | 345 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $29,985 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,985 | | Insurance broker organization code? | 3 | | Insurance broker name | LISA MAKA- WILLIAMS INS AGENCY INC |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 3 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 202 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,636 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,398 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,636 | | Insurance broker organization code? | 3 | | Insurance broker name | WILLIAMS INSURANCE CO |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 4 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 24 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $960 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CRITICAL ILLNESS COVERAGE | | Welfare Benefit Premiums Paid to Carrier | USD $2,706 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $761 | | Insurance broker organization code? | 3 | | Insurance broker name | BAFFIN BAY MARKETING GROUP |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 5 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 35 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,440 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENT COVERAGE | | Welfare Benefit Premiums Paid to Carrier | USD $5,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,126 | | Insurance broker organization code? | 3 | | Insurance broker name | BAFFIN BAY MARKETING GROUP |
|
| LEADERS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 74799 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 6 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 26 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,265 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,272 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,570 | | Insurance broker organization code? | 3 | | Insurance broker name | BROKER CENTRIC ALLIANCE, INC. |
|
| LEADERS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 74799 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 7 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 338 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $838 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,909 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $691 | | Insurance broker organization code? | 3 | | Insurance broker name | BAFFIN BAY MARKETING GROUP |
|
| LEADERS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 74799 ) |
| Policy contract number | SIOUXFALLS FORD |
| Policy instance | 8 |
| Insurance contract or identification number | SIOUXFALLS FORD | | Number of Individuals Covered | 111 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,771 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,307 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,446 | | Insurance broker organization code? | 3 | | Insurance broker name | BAFFIN BAY MARKETING GROUP |
|
| DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 ) |
| Policy contract number | 2645 |
| Policy instance | 1 |
| Insurance contract or identification number | 2645 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,747 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,429 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,747 | | Insurance broker organization code? | 3 | | Insurance broker name | LISA MAKA - WILLIAMS INS AGENCY INC |
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