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HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 401k Plan overview

Plan NameHORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN
Plan identification number 505

HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 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

401k Sponsoring company profile

HORNADY MANUFACTURING COMPANY has sponsored the creation of one or more 401k plans.

Company Name:HORNADY MANUFACTURING COMPANY
Employer identification number (EIN):470351752
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-01-01
5052021-01-01
5052020-01-01
5052019-01-01
5052018-01-01
5052017-01-01CARLA ROBERTSON CARLA ROBERTSON2018-10-12
5052016-01-01CARLA ROBERTSON CARLA ROBERTSON2017-10-14
5052015-04-01MARK KROEKER2016-04-08 MARK KROEKER2016-04-08

Plan Statistics for HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN

401k plan membership statisitcs for HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN

Measure Date Value
2022: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01907
Total number of active participants reported on line 7a of the Form 55002022-01-011,044
Number of retired or separated participants receiving benefits2022-01-014
Number of other retired or separated participants entitled to future benefits2022-01-0126
Total of all active and inactive participants2022-01-011,074
2021: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01708
Total number of active participants reported on line 7a of the Form 55002021-01-01881
Number of retired or separated participants receiving benefits2021-01-014
Number of other retired or separated participants entitled to future benefits2021-01-0122
Total of all active and inactive participants2021-01-01907
2020: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01640
Total number of active participants reported on line 7a of the Form 55002020-01-01687
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-0118
Total of all active and inactive participants2020-01-01708
2019: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01632
Total number of active participants reported on line 7a of the Form 55002019-01-01616
Number of retired or separated participants receiving benefits2019-01-016
Number of other retired or separated participants entitled to future benefits2019-01-0118
Total of all active and inactive participants2019-01-01640
2018: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01619
Total number of active participants reported on line 7a of the Form 55002018-01-01632
Number of retired or separated participants receiving benefits2018-01-014
Number of other retired or separated participants entitled to future benefits2018-01-0111
Total of all active and inactive participants2018-01-01647
2017: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01602
Total number of active participants reported on line 7a of the Form 55002017-01-01619
Number of retired or separated participants receiving benefits2017-01-014
Number of other retired or separated participants entitled to future benefits2017-01-016
Total of all active and inactive participants2017-01-01629
2016: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01595
Total number of active participants reported on line 7a of the Form 55002016-01-01602
Number of retired or separated participants receiving benefits2016-01-014
Number of other retired or separated participants entitled to future benefits2016-01-019
Total of all active and inactive participants2016-01-01615
2015: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-010
Total number of active participants reported on line 7a of the Form 55002015-04-01595
Number of retired or separated participants receiving benefits2015-04-012
Number of other retired or separated participants entitled to future benefits2015-04-0114
Total of all active and inactive participants2015-04-01611

Form 5500 Responses for HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN

2022: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 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: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 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: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 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: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 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: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 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: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 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: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 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: HORNADY MANUFACTURING COMPANY WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01First time form 5500 has been submittedYes
2015-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – General assets of the sponsorYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-052684
Policy instance 3
Insurance contract or identification number010-052684
Number of Individuals Covered1757
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,777
Total amount of fees paid to insurance companyUSD $2,753
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $146,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,777
Amount paid for insurance broker fees2753
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number803223G
Policy instance 2
Insurance contract or identification number803223G
Number of Individuals Covered1031
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $117,575
Total amount of fees paid to insurance companyUSD $5,902
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $691,621
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $103,466
Amount paid for insurance broker fees5902
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3205382
Policy instance 1
Insurance contract or identification numberE3205382
Number of Individuals Covered628
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $62,468
Total amount of fees paid to insurance companyUSD $6,726
Other welfare benefits providedCANCER AND ACUTE CARE
Welfare Benefit Premiums Paid to CarrierUSD $465,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,159
Amount paid for insurance broker fees4822
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-052684
Policy instance 3
Insurance contract or identification number010-052684
Number of Individuals Covered1606
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,605
Total amount of fees paid to insurance companyUSD $2,229
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $132,785
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,605
Amount paid for insurance broker fees2229
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number803223G
Policy instance 2
Insurance contract or identification number803223G
Number of Individuals Covered877
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $100,334
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $590,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $88,294
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3205382
Policy instance 1
Insurance contract or identification numberE3205382
Number of Individuals Covered573
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $60,231
Total amount of fees paid to insurance companyUSD $6,831
Other welfare benefits providedCANCER AND ACUTE CARE
Welfare Benefit Premiums Paid to CarrierUSD $439,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,826
Amount paid for insurance broker fees5070
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3205382
Policy instance 1
Insurance contract or identification numberE3205382
Number of Individuals Covered476
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $37,688
Total amount of fees paid to insurance companyUSD $2,446
Other welfare benefits providedCANCER AND ACUTE CARE
Welfare Benefit Premiums Paid to CarrierUSD $389,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,411
Amount paid for insurance broker fees1837
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30016906
Policy instance 2
Insurance contract or identification number30016906
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number803223G
Policy instance 3
Insurance contract or identification number803223G
Number of Individuals Covered779
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $87,269
Total amount of fees paid to insurance companyUSD $7,052
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $513,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $76,797
Amount paid for insurance broker fees7052
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-052684
Policy instance 4
Insurance contract or identification number010-052684
Number of Individuals Covered1335
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,395
Total amount of fees paid to insurance companyUSD $1,135
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $115,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,395
Amount paid for insurance broker fees1135
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0283830-SHORT
Policy instance 1
Insurance contract or identification number0283830-SHORT
Number of Individuals Covered634
Insurance policy start date2019-01-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $13,234
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $81,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,249
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3205382
Policy instance 2
Insurance contract or identification numberE3205382
Number of Individuals Covered443
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $46,683
Total amount of fees paid to insurance companyUSD $3,836
Other welfare benefits providedCANCER AND ACUTE CARE
Welfare Benefit Premiums Paid to CarrierUSD $338,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,403
Amount paid for insurance broker fees2270
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30016906
Policy instance 3
Insurance contract or identification number30016906
Number of Individuals Covered545
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,861
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,861
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number803223G
Policy instance 4
Insurance contract or identification number803223G
Number of Individuals Covered737
Insurance policy start date2019-03-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $63,291
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $372,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,696
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number405788 0010
Policy instance 4
Insurance contract or identification number405788 0010
Number of Individuals Covered626
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,932
Welfare Benefit Premiums Paid to CarrierUSD $784,236
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,932
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30016906
Policy instance 3
Insurance contract or identification number30016906
Number of Individuals Covered554
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,976
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $109,798
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,976
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3205382
Policy instance 2
Insurance contract or identification numberE3205382
Number of Individuals Covered468
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $45,872
Total amount of fees paid to insurance companyUSD $4,952
Other welfare benefits providedCANCER AND ACUTE CARE
Welfare Benefit Premiums Paid to CarrierUSD $373,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,417
Amount paid for insurance broker fees3664
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0283830
Policy instance 1
Insurance contract or identification number0283830
Number of Individuals Covered1275
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $77,786
Total amount of fees paid to insurance companyUSD $11,646
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $468,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,575
Amount paid for insurance broker fees11646
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0283830
Policy instance 1
Insurance contract or identification number0283830
Number of Individuals Covered1242
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $74,551
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $455,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $63,372
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORS SERVICES GROUP
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3205382
Policy instance 2
Insurance contract or identification numberE3205382
Number of Individuals Covered476
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $53,219
Total amount of fees paid to insurance companyUSD $6,970
Other welfare benefits providedCANCER AND ACUTE CARE
Welfare Benefit Premiums Paid to CarrierUSD $320,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,426
Insurance broker organization code?3
Amount paid for insurance broker fees4277
Additional information about fees paid to insurance brokerFEES
Insurance broker nameR C SCHOPP & ASSOCIATES INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30016906
Policy instance 3
Insurance contract or identification number30016906
Number of Individuals Covered526
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,876
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $120,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,876
Insurance broker organization code?3
Insurance broker nameHOLMES MURPHY & ASSOCIATES, LLC
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number405788-A
Policy instance 4
Insurance contract or identification number405788-A
Number of Individuals Covered619
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $49,109
Welfare Benefit Premiums Paid to CarrierUSD $701,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,078
Insurance broker organization code?3
Insurance broker nameBENEFIT ADMINISTRATIVE SYSTEMS
STOP LOSS COVERAGE (National Association of Insurance Commissioners NAIC id number: 52254 )
Policy contract numberUS221003
Policy instance 4
Insurance contract or identification numberUS221003
Number of Individuals Covered559
Insurance policy start date2015-04-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $82,019
Welfare Benefit Premiums Paid to CarrierUSD $546,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $76,551
Insurance broker organization code?3
Insurance broker nameBENEFIT ADMINISTRATIVE SYSTEMS
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30016906
Policy instance 3
Insurance contract or identification number30016906
Number of Individuals Covered458
Insurance policy start date2015-04-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,352
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,352
Insurance broker organization code?3
Insurance broker nameHOLMES MURPHY & ASSOCIATES, LLC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3205382
Policy instance 2
Insurance contract or identification numberE3205382
Number of Individuals Covered383
Insurance policy start date2015-04-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $31,320
Total amount of fees paid to insurance companyUSD $3,674
Other welfare benefits providedCANCER AND ACUTE CARE
Welfare Benefit Premiums Paid to CarrierUSD $205,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $175
Insurance broker organization code?3
Amount paid for insurance broker fees4
Additional information about fees paid to insurance brokerFEES
Insurance broker nameCRISS BUTLER
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number687631G
Policy instance 1
Insurance contract or identification number687631G
Number of Individuals Covered699
Insurance policy start date2015-04-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $33,128
Total amount of fees paid to insurance companyUSD $5,335
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $332,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,128
Amount paid for insurance broker fees5335
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameHOLMES MURPHY & ASSOC INC

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