HAMPSHIRE PET PRODUCTS, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946
401k plan membership statisitcs for HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946
| Measure | Date | Value |
|---|
| 2019: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-07-01 | 481 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 308 |
| Total of all active and inactive participants | 2019-07-01 | 308 |
| Total participants | 2019-07-01 | 308 |
| 2018: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 363 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 481 |
| Total of all active and inactive participants | 2018-07-01 | 481 |
| Total participants | 2018-07-01 | 481 |
| 2017: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 381 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 363 |
| Total of all active and inactive participants | 2017-07-01 | 363 |
| Total participants | 2017-07-01 | 363 |
| 2016: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 542 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 381 |
| Total of all active and inactive participants | 2016-07-01 | 381 |
| Total participants | 2016-07-01 | 381 |
| 2015: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 467 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 542 |
| Total of all active and inactive participants | 2015-07-01 | 542 |
| Total participants | 2015-07-01 | 542 |
| 2014: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 391 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 467 |
| Total of all active and inactive participants | 2014-07-01 | 467 |
| Total participants | 2014-07-01 | 467 |
| 2013: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 230 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 391 |
| Total of all active and inactive participants | 2013-07-01 | 391 |
| Total participants | 2013-07-01 | 391 |
| 2012: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 292 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 230 |
| Total of all active and inactive participants | 2012-07-01 | 230 |
| 2011: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 128 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 292 |
| Total of all active and inactive participants | 2011-07-01 | 292 |
| 2010: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-07-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 128 |
| Total of all active and inactive participants | 2010-07-01 | 128 |
| 2009: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 117 |
| Total of all active and inactive participants | 2009-07-01 | 117 |
| 2008: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-07-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-07-01 | 108 |
| Total of all active and inactive participants | 2008-07-01 | 108 |
| 2007: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-07-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-07-01 | 103 |
| Total of all active and inactive participants | 2007-07-01 | 103 |
| Measure | Date | Value |
|---|
| 2020 : HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2020 401k financial data |
|---|
| Total income from all sources (including contributions) | 2020-06-30 | $999,351 |
| Total of all expenses incurred | 2020-06-30 | $999,351 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-06-30 | $999,351 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-06-30 | $999,351 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-06-30 | No |
| Was this plan covered by a fidelity bond | 2020-06-30 | Yes |
| Value of fidelity bond cover | 2020-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2020-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-06-30 | No |
| Contributions received from participants | 2020-06-30 | $696,656 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Value of net income/loss | 2020-06-30 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-06-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-06-30 | $999,351 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-06-30 | No |
| Contributions received in cash from employer | 2020-06-30 | $302,695 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-06-30 | No |
| Did the plan have assets held for investment | 2020-06-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-06-30 | No |
| 2019 : HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2019 401k financial data |
|---|
| Total income from all sources (including contributions) | 2019-06-30 | $1,133,320 |
| Total of all expenses incurred | 2019-06-30 | $1,133,320 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-06-30 | $1,133,320 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-06-30 | $1,133,320 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-06-30 | No |
| Was this plan covered by a fidelity bond | 2019-06-30 | Yes |
| Value of fidelity bond cover | 2019-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2019-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-06-30 | No |
| Contributions received from participants | 2019-06-30 | $386,781 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Value of net income/loss | 2019-06-30 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-06-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-06-30 | $1,133,320 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-06-30 | No |
| Contributions received in cash from employer | 2019-06-30 | $746,539 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-06-30 | No |
| Did the plan have assets held for investment | 2019-06-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-06-30 | No |
| 2017 : HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2017 401k financial data |
|---|
| Total income from all sources | 2017-06-30 | $1,145,418 |
| Expenses. Total of all expenses incurred | 2017-06-30 | $1,145,418 |
| Benefits paid (including direct rollovers) | 2017-06-30 | $1,145,418 |
| Value of fidelity bond covering the plan | 2017-06-30 | $1,000,000 |
| Total contributions received or receivable from participants | 2017-06-30 | $356,244 |
| Contributions received from other sources (not participants or employers) | 2017-06-30 | $32,487 |
| Total contributions received or receivable from employer(s) | 2017-06-30 | $756,687 |
| 2016 : HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2016 401k financial data |
|---|
| Total income from all sources | 2016-06-30 | $1,091,615 |
| Expenses. Total of all expenses incurred | 2016-06-30 | $1,091,615 |
| Benefits paid (including direct rollovers) | 2016-06-30 | $1,091,615 |
| Value of fidelity bond covering the plan | 2016-06-30 | $1,000,000 |
| Total contributions received or receivable from participants | 2016-06-30 | $332,132 |
| Contributions received from other sources (not participants or employers) | 2016-06-30 | $16,428 |
| Total contributions received or receivable from employer(s) | 2016-06-30 | $743,055 |
| 2015 : HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2015 401k financial data |
|---|
| Total income from all sources | 2015-06-30 | $895,158 |
| Expenses. Total of all expenses incurred | 2015-06-30 | $895,158 |
| Benefits paid (including direct rollovers) | 2015-06-30 | $895,158 |
| Value of fidelity bond covering the plan | 2015-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2015-06-30 | $291,108 |
| Total contributions received or receivable from employer(s) | 2015-06-30 | $604,050 |
| 2014 : HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2014 401k financial data |
|---|
| Total income from all sources | 2014-06-30 | $915,645 |
| Expenses. Total of all expenses incurred | 2014-06-30 | $915,645 |
| Benefits paid (including direct rollovers) | 2014-06-30 | $915,645 |
| Value of fidelity bond covering the plan | 2014-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2014-06-30 | $337,743 |
| Total contributions received or receivable from employer(s) | 2014-06-30 | $577,902 |
| 2013 : HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2013 401k financial data |
|---|
| Total income from all sources | 2013-06-30 | $863,444 |
| Expenses. Total of all expenses incurred | 2013-06-30 | $863,444 |
| Benefits paid (including direct rollovers) | 2013-06-30 | $863,444 |
| Value of fidelity bond covering the plan | 2013-06-30 | $250,000 |
| Total contributions received or receivable from participants | 2013-06-30 | $317,958 |
| Contributions received from other sources (not participants or employers) | 2013-06-30 | $4,136 |
| Net income (gross income less expenses) | 2013-06-30 | $0 |
| Total contributions received or receivable from employer(s) | 2013-06-30 | $541,350 |
| 2012 : HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2012 401k financial data |
|---|
| Total income from all sources | 2012-06-30 | $759,752 |
| Expenses. Total of all expenses incurred | 2012-06-30 | $759,752 |
| Benefits paid (including direct rollovers) | 2012-06-30 | $759,752 |
| Value of fidelity bond covering the plan | 2012-06-30 | $250,000 |
| Total contributions received or receivable from participants | 2012-06-30 | $297,016 |
| Contributions received from other sources (not participants or employers) | 2012-06-30 | $1,713 |
| Net income (gross income less expenses) | 2012-06-30 | $0 |
| Total contributions received or receivable from employer(s) | 2012-06-30 | $461,023 |
| 2011 : HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2011 401k financial data |
|---|
| Total income from all sources | 2011-06-30 | $749,458 |
| Expenses. Total of all expenses incurred | 2011-06-30 | $749,458 |
| Benefits paid (including direct rollovers) | 2011-06-30 | $749,458 |
| Value of fidelity bond covering the plan | 2011-06-30 | $100,000 |
| Total contributions received or receivable from participants | 2011-06-30 | $289,293 |
| Contributions received from other sources (not participants or employers) | 2011-06-30 | $100 |
| Net income (gross income less expenses) | 2011-06-30 | $0 |
| Total contributions received or receivable from employer(s) | 2011-06-30 | $460,065 |
| 2019: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2019 form 5500 responses |
|---|
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2018 form 5500 responses |
|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2010 form 5500 responses |
|---|
| 2010-07-01 | Type of plan entity | Single employer plan |
| 2010-07-01 | Plan funding arrangement – Insurance | Yes |
| 2010-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2008 form 5500 responses |
|---|
| 2008-07-01 | Type of plan entity | Single employer plan |
| 2008-07-01 | This submission is the final filing | No |
| 2008-07-01 | Plan funding arrangement – Insurance | Yes |
| 2008-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2008-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2007: HAMPSHIRE PET PRODUCTS LLC 7502 EAST 26TH STREET JOPLIN, MO 64804-7946 2007 form 5500 responses |
|---|
| 2007-07-01 | Type of plan entity | Single employer plan |
| 2007-07-01 | First time form 5500 has been submitted | Yes |
| 2007-07-01 | This submission is the final filing | No |
| 2007-07-01 | Plan funding arrangement – Insurance | Yes |
| 2007-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2007-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 877421G |
| Policy instance | 1 |
| Insurance contract or identification number | 877421G | | Number of Individuals Covered | 195 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $6,988 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $74,414 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,735 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0911482 |
| Policy instance | 2 |
| Insurance contract or identification number | 0911482 | | Number of Individuals Covered | 308 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $36,400 | | Total amount of fees paid to insurance company | USD $26,143 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,374,772 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31,441 | | Amount paid for insurance broker fees | 8118 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E4433124 |
| Policy instance | 3 |
| Insurance contract or identification number | E4433124 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $12,425 | | Total amount of fees paid to insurance company | USD $1,446 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $88,949 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,131 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0911482 |
| Policy instance | 2 |
| Insurance contract or identification number | 0911482 | | Number of Individuals Covered | 481 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $8,957 | | Total amount of fees paid to insurance company | USD $22,294 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,197,380 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,957 | | Amount paid for insurance broker fees | 22294 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 877421G |
| Policy instance | 1 |
| Insurance contract or identification number | 877421G | | Number of Individuals Covered | 219 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $7,725 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $82,572 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,725 | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E4433124 |
| Policy instance | 3 |
| Insurance contract or identification number | E4433124 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $29,288 | | Total amount of fees paid to insurance company | USD $5,007 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $105,537 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,816 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 877421G |
| Policy instance | 2 |
| Insurance contract or identification number | 877421G | | Number of Individuals Covered | 211 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $7,506 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $78,650 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 911482 |
| Policy instance | 1 |
| Insurance contract or identification number | 911482 | | Number of Individuals Covered | 363 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $8,997 | | Total amount of fees paid to insurance company | USD $21,489 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,148,876 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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