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EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 401k Plan overview

Plan NameEMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS
Plan identification number 507

EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

BMO FINANCIAL CORP. has sponsored the creation of one or more 401k plans.

Company Name:BMO FINANCIAL CORP.
Employer identification number (EIN):510275712
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072022-01-01
5072021-01-01
5072020-01-01
5072019-01-01
5072018-01-01
5072017-01-01GARY M. HANSEN

Plan Statistics for EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS

401k plan membership statisitcs for EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS

Measure Date Value
2022: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2022 401k membership
Total participants, beginning-of-year2022-01-0111,007
Total number of active participants reported on line 7a of the Form 55002022-01-018,376
Number of retired or separated participants receiving benefits2022-01-012,076
Total of all active and inactive participants2022-01-0110,452
2021: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2021 401k membership
Total participants, beginning-of-year2021-01-0111,540
Total number of active participants reported on line 7a of the Form 55002021-01-018,843
Number of retired or separated participants receiving benefits2021-01-012,164
Total of all active and inactive participants2021-01-0111,007
2020: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2020 401k membership
Total participants, beginning-of-year2020-01-0110,616
Total number of active participants reported on line 7a of the Form 55002020-01-019,303
Number of retired or separated participants receiving benefits2020-01-012,237
Total of all active and inactive participants2020-01-0111,540
2019: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2019 401k membership
Total participants, beginning-of-year2019-01-0111,196
Total number of active participants reported on line 7a of the Form 55002019-01-018,412
Number of retired or separated participants receiving benefits2019-01-012,204
Total of all active and inactive participants2019-01-0110,616
2018: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2018 401k membership
Total participants, beginning-of-year2018-01-0111,539
Total number of active participants reported on line 7a of the Form 55002018-01-019,063
Number of retired or separated participants receiving benefits2018-01-012,133
Total of all active and inactive participants2018-01-0111,196
2017: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2017 401k membership
Total participants, beginning-of-year2017-01-0111,598
Total number of active participants reported on line 7a of the Form 55002017-01-019,355
Number of retired or separated participants receiving benefits2017-01-012,184
Total of all active and inactive participants2017-01-0111,539

Financial Data on EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS

Measure Date Value
2022 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2022 401k financial data
Total income from all sources (including contributions)2022-12-31$160,982,848
Total of all expenses incurred2022-12-31$166,572,377
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$158,993,985
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$159,642,200
Value of total assets at end of year2022-12-31$88,232,104
Value of total assets at beginning of year2022-12-31$93,821,633
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$7,578,392
Total interest from all sources2022-12-31$1,153,414
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$187,234
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$187,234
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$36,845,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$45,749,636
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$249,942
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$815
Administrative expenses (other) incurred2022-12-31$1,578,429
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-5,589,529
Value of net assets at end of year (total assets less liabilities)2022-12-31$88,232,104
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$93,821,633
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$87,982,162
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$93,820,818
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$1,153,414
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$13,369,341
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$113,892,564
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$145,624,644
Contract administrator fees2022-12-31$5,999,963
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31GJC CPA'S & ADVISORS
Accountancy firm EIN2022-12-31270475249
2021 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2021 401k financial data
Total income from all sources (including contributions)2021-12-31$151,624,900
Total of all expenses incurred2021-12-31$156,988,390
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$150,437,331
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$151,567,153
Value of total assets at end of year2021-12-31$93,821,633
Value of total assets at beginning of year2021-12-31$99,185,123
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$6,551,059
Total interest from all sources2021-12-31$33,095
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$24,598
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$24,598
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$39,555,500
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$47,230,575
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$815
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$714
Administrative expenses (other) incurred2021-12-31$3,521,548
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-5,363,490
Value of net assets at end of year (total assets less liabilities)2021-12-31$93,821,633
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$99,185,123
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$93,820,818
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$99,184,409
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$33,095
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$14,722,110
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$54
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$104,336,578
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$135,715,221
Contract administrator fees2021-12-31$3,029,511
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31GEORGE JOHNSON & COMPANY OF IL, LLC
Accountancy firm EIN2021-12-31270475249
2020 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2020 401k financial data
Total income from all sources (including contributions)2020-12-31$150,209,351
Total of all expenses incurred2020-12-31$155,058,808
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$140,748,186
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$145,809,702
Value of total assets at end of year2020-12-31$99,185,123
Value of total assets at beginning of year2020-12-31$104,034,580
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$14,310,622
Total interest from all sources2020-12-31$41,056
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$1,147,412
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$1,147,412
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$38,461,538
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$49,049,744
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$714
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$111,364
Administrative expenses (other) incurred2020-12-31$9,750,986
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-4,849,457
Value of net assets at end of year (total assets less liabilities)2020-12-31$99,185,123
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$104,034,580
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$99,184,409
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$103,923,216
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$41,056
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$14,816,114
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$3,211,181
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$96,759,958
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$125,932,072
Contract administrator fees2020-12-31$4,559,636
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31GEORGE JOHNSON & COMPANY OF IL, LLC
Accountancy firm EIN2020-12-31270475249
2019 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2019 401k financial data
Total income from all sources (including contributions)2019-12-31$158,943,998
Total of all expenses incurred2019-12-31$153,505,709
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$144,076,013
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$147,473,045
Value of total assets at end of year2019-12-31$104,034,580
Value of total assets at beginning of year2019-12-31$98,596,291
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$9,429,696
Total interest from all sources2019-12-31$156,109
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$2,433,802
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$2,433,802
Administrative expenses professional fees incurred2019-12-31$1,000
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$36,696,500
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$48,143,244
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$111,364
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$163,490
Administrative expenses (other) incurred2019-12-31$5,346,976
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$5,438,289
Value of net assets at end of year (total assets less liabilities)2019-12-31$104,034,580
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$98,596,291
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$103,923,216
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$98,432,801
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$156,109
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$15,250,614
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$8,881,042
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$99,329,801
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$128,825,399
Contract administrator fees2019-12-31$4,081,720
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31GEORGE JOHNSON & COMPANY OF IL, LLC
Accountancy firm EIN2019-12-31270475249
2018 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2018 401k financial data
Total income from all sources (including contributions)2018-12-31$145,786,164
Total of all expenses incurred2018-12-31$158,037,745
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$144,649,332
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$145,913,140
Value of total assets at end of year2018-12-31$98,596,291
Value of total assets at beginning of year2018-12-31$110,847,872
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$13,388,413
Total interest from all sources2018-12-31$159,168
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$2,352,577
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$2,352,577
Administrative expenses professional fees incurred2018-12-31$49,561
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$238,470,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$61,904,923
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$163,490
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$95,539
Administrative expenses (other) incurred2018-12-31$9,272,773
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-12,251,581
Value of net assets at end of year (total assets less liabilities)2018-12-31$98,596,291
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$110,847,872
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$98,432,801
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$110,752,333
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$159,168
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$13,596,460
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-2,638,721
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$84,008,217
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$131,052,872
Contract administrator fees2018-12-31$4,066,079
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31GEORGE JOHNSON & COMPANY OF IL, LLC
Accountancy firm EIN2018-12-31270475249
2017 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$181,759,359
Total of all expenses incurred2017-12-31$170,533,452
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$157,557,131
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$172,948,239
Value of total assets at end of year2017-12-31$110,847,872
Value of total assets at beginning of year2017-12-31$99,621,965
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$12,976,321
Total interest from all sources2017-12-31$207,967
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$1,678,601
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$1,678,601
Administrative expenses professional fees incurred2017-12-31$39,798
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$238,470,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$61,104,312
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$95,539
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$66,451
Administrative expenses (other) incurred2017-12-31$8,647,788
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$11,225,907
Value of net assets at end of year (total assets less liabilities)2017-12-31$110,847,872
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$99,621,965
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$110,752,333
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$99,555,514
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$207,967
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$36,555,826
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$6,924,552
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$111,843,927
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$121,001,305
Contract administrator fees2017-12-31$4,288,735
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31GEORGE JOHNSON & COMPANY OF IL, LLC
Accountancy firm EIN2017-12-31270475249

Form 5500 Responses for EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS

2022: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number29316-4
Policy instance 2
Insurance contract or identification number29316-4
Number of Individuals Covered20798
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,866,136
Total amount of fees paid to insurance companyUSD $382,933
Life Insurance Welfare BenefitYes
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $9,731,563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,807,291
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
Amount paid for insurance broker fees248612
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number5316
Policy instance 6
Insurance contract or identification number5316
Number of Individuals Covered24086
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number074686
Policy instance 5
Insurance contract or identification number074686
Number of Individuals Covered22228
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $9,035
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees9035
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number887423
Policy instance 4
Insurance contract or identification number887423
Number of Individuals Covered16
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,480
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $171,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3480
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30028445
Policy instance 3
Insurance contract or identification number30028445
Number of Individuals Covered8580
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CHARTIS INSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberGTP 9427924
Policy instance 7
Insurance contract or identification numberGTP 9427924
Number of Individuals Covered12868
Insurance policy start date2022-04-30
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number87240
Policy instance 1
Insurance contract or identification number87240
Number of Individuals Covered525
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $10,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number87240
Policy instance 1
Insurance contract or identification number87240
Number of Individuals Covered576
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $11,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number29316-4
Policy instance 2
Insurance contract or identification number29316-4
Number of Individuals Covered19778
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $498,037
Total amount of fees paid to insurance companyUSD $364,152
Life Insurance Welfare BenefitYes
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $9,168,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $417,187
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
Amount paid for insurance broker fees231678
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number9907-46-29
Policy instance 3
Insurance contract or identification number9907-46-29
Number of Individuals Covered115
Insurance policy start date2020-10-31
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30028445
Policy instance 4
Insurance contract or identification number30028445
Number of Individuals Covered8096
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number887423
Policy instance 5
Insurance contract or identification number887423
Number of Individuals Covered17
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,385
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $213,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,385
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number074686
Policy instance 6
Insurance contract or identification number074686
Number of Individuals Covered10112
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $7,519
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees7519
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number5316
Policy instance 7
Insurance contract or identification number5316
Number of Individuals Covered23626
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number29316-4
Policy instance 2
Insurance contract or identification number29316-4
Number of Individuals Covered20379
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $218,111
Total amount of fees paid to insurance companyUSD $236,547
Life Insurance Welfare BenefitYes
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $8,018,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees236547
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $155,294
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number87240
Policy instance 1
Insurance contract or identification number87240
Number of Individuals Covered6764
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $827,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number9907-46-29
Policy instance 3
Insurance contract or identification number9907-46-29
Number of Individuals Covered115
Insurance policy start date2019-10-31
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $13,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30028445
Policy instance 4
Insurance contract or identification number30028445
Number of Individuals Covered8462
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number887423
Policy instance 5
Insurance contract or identification number887423
Number of Individuals Covered27
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $280,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number074686
Policy instance 6
Insurance contract or identification number074686
Number of Individuals Covered10758
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $10,426
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees10426
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number5316
Policy instance 7
Insurance contract or identification number5316
Number of Individuals Covered24330
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number887423
Policy instance 5
Insurance contract or identification number887423
Number of Individuals Covered29
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $221,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number5316
Policy instance 7
Insurance contract or identification number5316
Number of Individuals Covered25845
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number9907-46-29
Policy instance 3
Insurance contract or identification number9907-46-29
Number of Individuals Covered16191
Insurance policy start date2018-10-31
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $13,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number87240
Policy instance 1
Insurance contract or identification number87240
Number of Individuals Covered6812
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $814,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number29316-4
Policy instance 2
Insurance contract or identification number29316-4
Number of Individuals Covered22009
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $222,653
Total amount of fees paid to insurance companyUSD $203,685
Life Insurance Welfare BenefitYes
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $7,597,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees203685
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $159,284
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number074686
Policy instance 6
Insurance contract or identification number074686
Number of Individuals Covered11271
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $14,727
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees14700
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30028445
Policy instance 4
Insurance contract or identification number30028445
Number of Individuals Covered8951
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number87240
Policy instance 1
Insurance contract or identification number87240
Number of Individuals Covered6374
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $759,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITY HEALTH PLANS INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95796 )
Policy contract number900017
Policy instance 4
Insurance contract or identification number900017
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $-128,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number074686
Policy instance 7
Insurance contract or identification number074686
Number of Individuals Covered11318
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $9,531
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees9389
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number5316
Policy instance 8
Insurance contract or identification number5316
Number of Individuals Covered26237
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number887423
Policy instance 6
Insurance contract or identification number887423
Number of Individuals Covered23
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $421,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30028445
Policy instance 5
Insurance contract or identification number30028445
Number of Individuals Covered8993
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number9907-46-29
Policy instance 3
Insurance contract or identification number9907-46-29
Number of Individuals Covered14113
Insurance policy start date2017-10-31
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $13,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number29316-4
Policy instance 2
Insurance contract or identification number29316-4
Number of Individuals Covered21836
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $263,652
Total amount of fees paid to insurance companyUSD $151,020
Life Insurance Welfare BenefitYes
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $6,696,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $154,445
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
Amount paid for insurance broker fees151020
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberB74689/H74686
Policy instance 7
Insurance contract or identification numberB74689/H74686
Number of Individuals Covered4031
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,026,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number6409 7500
Policy instance 6
Insurance contract or identification number6409 7500
Number of Individuals Covered14071
Insurance policy start date2016-10-31
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $13,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number600690
Policy instance 5
Insurance contract or identification number600690
Number of Individuals Covered56
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $256,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number29316-4
Policy instance 4
Insurance contract or identification number29316-4
Number of Individuals Covered31607
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $220,427
Total amount of fees paid to insurance companyUSD $101,101
Life Insurance Welfare BenefitYes
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $6,216,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $154,632
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
Amount paid for insurance broker fees101101
Insurance broker nameEOI SERVICE COMPANY, INC.
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberBM1658
Policy instance 3
Insurance contract or identification numberBM1658
Number of Individuals Covered156
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,509,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number87240
Policy instance 2
Insurance contract or identification number87240
Number of Individuals Covered5357
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $687,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number1034
Policy instance 8
Insurance contract or identification number1034
Number of Individuals Covered324
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,843,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN (National Association of Insurance Commissioners NAIC id number: 95311 )
Policy contract number383
Policy instance 9
Insurance contract or identification number383
Number of Individuals Covered160
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $800,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 )
Policy contract number100640
Policy instance 10
Insurance contract or identification number100640
Number of Individuals Covered3
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,897
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITY HEALTH PLANS INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95796 )
Policy contract number900017
Policy instance 11
Insurance contract or identification number900017
Number of Individuals Covered225
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,748,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30028445
Policy instance 12
Insurance contract or identification number30028445
Number of Individuals Covered8699
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,365,663
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 )
Policy contract number100620
Policy instance 13
Insurance contract or identification number100620
Number of Individuals Covered71
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $360,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 )
Policy contract number180750
Policy instance 14
Insurance contract or identification number180750
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number887423
Policy instance 15
Insurance contract or identification number887423
Number of Individuals Covered22
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $187,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number074686
Policy instance 16
Insurance contract or identification number074686
Number of Individuals Covered10610
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number697953
Policy instance 1
Insurance contract or identification number697953
Number of Individuals Covered4313
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,188,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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