BMO FINANCIAL CORP. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS
401k plan membership statisitcs for EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS
Measure | Date | Value |
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2022 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2022 401k financial data |
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Total income from all sources (including contributions) | 2022-12-31 | $160,982,848 |
Total of all expenses incurred | 2022-12-31 | $166,572,377 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $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 year | 2022-12-31 | $88,232,104 |
Value of total assets at beginning of year | 2022-12-31 | $93,821,633 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $7,578,392 |
Total interest from all sources | 2022-12-31 | $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 year | 2022-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $187,234 |
Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
Value of fidelity bond cover | 2022-12-31 | $36,845,000 |
Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
Contributions received from participants | 2022-12-31 | $45,749,636 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $249,942 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $815 |
Administrative expenses (other) incurred | 2022-12-31 | $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 appraiser | 2022-12-31 | No |
Value of net income/loss | 2022-12-31 | $-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) | 2022-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $87,982,162 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $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 benefits | 2022-12-31 | $13,369,341 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
Contributions received in cash from employer | 2022-12-31 | $113,892,564 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $145,624,644 |
Contract administrator fees | 2022-12-31 | $5,999,963 |
Did the plan have assets held for investment | 2022-12-31 | Yes |
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 | 2022-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
Accountancy firm name | 2022-12-31 | GJC CPA'S & ADVISORS |
Accountancy firm EIN | 2022-12-31 | 270475249 |
2021 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2021 401k financial data |
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Total income from all sources (including contributions) | 2021-12-31 | $151,624,900 |
Total of all expenses incurred | 2021-12-31 | $156,988,390 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $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 year | 2021-12-31 | $93,821,633 |
Value of total assets at beginning of year | 2021-12-31 | $99,185,123 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $6,551,059 |
Total interest from all sources | 2021-12-31 | $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 year | 2021-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $24,598 |
Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
Value of fidelity bond cover | 2021-12-31 | $39,555,500 |
Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
Contributions received from participants | 2021-12-31 | $47,230,575 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $815 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $714 |
Administrative expenses (other) incurred | 2021-12-31 | $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 appraiser | 2021-12-31 | No |
Value of net income/loss | 2021-12-31 | $-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) | 2021-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $93,820,818 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $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 benefits | 2021-12-31 | $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 assets | 2021-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
Contributions received in cash from employer | 2021-12-31 | $104,336,578 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $135,715,221 |
Contract administrator fees | 2021-12-31 | $3,029,511 |
Did the plan have assets held for investment | 2021-12-31 | Yes |
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 | 2021-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
Accountancy firm name | 2021-12-31 | GEORGE JOHNSON & COMPANY OF IL, LLC |
Accountancy firm EIN | 2021-12-31 | 270475249 |
2020 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2020 401k financial data |
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Total income from all sources (including contributions) | 2020-12-31 | $150,209,351 |
Total of all expenses incurred | 2020-12-31 | $155,058,808 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $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 year | 2020-12-31 | $99,185,123 |
Value of total assets at beginning of year | 2020-12-31 | $104,034,580 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $14,310,622 |
Total interest from all sources | 2020-12-31 | $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 year | 2020-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $1,147,412 |
Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
Value of fidelity bond cover | 2020-12-31 | $38,461,538 |
Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
Contributions received from participants | 2020-12-31 | $49,049,744 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $714 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $111,364 |
Administrative expenses (other) incurred | 2020-12-31 | $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 appraiser | 2020-12-31 | No |
Value of net income/loss | 2020-12-31 | $-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) | 2020-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $99,184,409 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $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 benefits | 2020-12-31 | $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 assets | 2020-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
Contributions received in cash from employer | 2020-12-31 | $96,759,958 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $125,932,072 |
Contract administrator fees | 2020-12-31 | $4,559,636 |
Did the plan have assets held for investment | 2020-12-31 | Yes |
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 | 2020-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
Accountancy firm name | 2020-12-31 | GEORGE JOHNSON & COMPANY OF IL, LLC |
Accountancy firm EIN | 2020-12-31 | 270475249 |
2019 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2019 401k financial data |
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Total income from all sources (including contributions) | 2019-12-31 | $158,943,998 |
Total of all expenses incurred | 2019-12-31 | $153,505,709 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $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 year | 2019-12-31 | $104,034,580 |
Value of total assets at beginning of year | 2019-12-31 | $98,596,291 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $9,429,696 |
Total interest from all sources | 2019-12-31 | $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 year | 2019-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $2,433,802 |
Administrative expenses professional fees incurred | 2019-12-31 | $1,000 |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Value of fidelity bond cover | 2019-12-31 | $36,696,500 |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Contributions received from participants | 2019-12-31 | $48,143,244 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $111,364 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $163,490 |
Administrative expenses (other) incurred | 2019-12-31 | $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 appraiser | 2019-12-31 | No |
Value of net income/loss | 2019-12-31 | $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) | 2019-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $103,923,216 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $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 benefits | 2019-12-31 | $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 assets | 2019-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
Contributions received in cash from employer | 2019-12-31 | $99,329,801 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $128,825,399 |
Contract administrator fees | 2019-12-31 | $4,081,720 |
Did the plan have assets held for investment | 2019-12-31 | Yes |
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 | 2019-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
Accountancy firm name | 2019-12-31 | GEORGE JOHNSON & COMPANY OF IL, LLC |
Accountancy firm EIN | 2019-12-31 | 270475249 |
2018 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2018 401k financial data |
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Total income from all sources (including contributions) | 2018-12-31 | $145,786,164 |
Total of all expenses incurred | 2018-12-31 | $158,037,745 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $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 year | 2018-12-31 | $98,596,291 |
Value of total assets at beginning of year | 2018-12-31 | $110,847,872 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $13,388,413 |
Total interest from all sources | 2018-12-31 | $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 year | 2018-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2018-12-31 | $2,352,577 |
Administrative expenses professional fees incurred | 2018-12-31 | $49,561 |
Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
Value of fidelity bond cover | 2018-12-31 | $238,470,000 |
Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
Contributions received from participants | 2018-12-31 | $61,904,923 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $163,490 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $95,539 |
Administrative expenses (other) incurred | 2018-12-31 | $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 appraiser | 2018-12-31 | No |
Value of net income/loss | 2018-12-31 | $-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) | 2018-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $98,432,801 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $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 benefits | 2018-12-31 | $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 assets | 2018-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
Contributions received in cash from employer | 2018-12-31 | $84,008,217 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $131,052,872 |
Contract administrator fees | 2018-12-31 | $4,066,079 |
Did the plan have assets held for investment | 2018-12-31 | Yes |
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 | 2018-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
Accountancy firm name | 2018-12-31 | GEORGE JOHNSON & COMPANY OF IL, LLC |
Accountancy firm EIN | 2018-12-31 | 270475249 |
2017 : EMPLOYEE BENEFIT PROGRAM OF BANK OF MONTREAL/HARRIS 2017 401k financial data |
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Total income from all sources (including contributions) | 2017-12-31 | $181,759,359 |
Total of all expenses incurred | 2017-12-31 | $170,533,452 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $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 year | 2017-12-31 | $110,847,872 |
Value of total assets at beginning of year | 2017-12-31 | $99,621,965 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $12,976,321 |
Total interest from all sources | 2017-12-31 | $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 year | 2017-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2017-12-31 | $1,678,601 |
Administrative expenses professional fees incurred | 2017-12-31 | $39,798 |
Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
Value of fidelity bond cover | 2017-12-31 | $238,470,000 |
If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
Contributions received from participants | 2017-12-31 | $61,104,312 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $95,539 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $66,451 |
Administrative expenses (other) incurred | 2017-12-31 | $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 appraiser | 2017-12-31 | No |
Value of net income/loss | 2017-12-31 | $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) | 2017-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $110,752,333 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $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 benefits | 2017-12-31 | $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 assets | 2017-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
Contributions received in cash from employer | 2017-12-31 | $111,843,927 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $121,001,305 |
Contract administrator fees | 2017-12-31 | $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 2520.101-3 | 2017-12-31 | No |
Did the plan have assets held for investment | 2017-12-31 | Yes |
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 | 2017-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
Accountancy firm name | 2017-12-31 | GEORGE JOHNSON & COMPANY OF IL, LLC |
Accountancy firm EIN | 2017-12-31 | 270475249 |
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 29316-4 |
Policy instance | 2 |
Insurance contract or identification number | 29316-4 | Number of Individuals Covered | 20798 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,866,136 | Total amount of fees paid to insurance company | USD $382,933 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | INDIVIDUAL EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $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 Broker | USD $1,807,291 | Additional information about fees paid to insurance broker | WRITING AGENT | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 248612 |
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EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
Policy contract number | 5316 |
Policy instance | 6 |
Insurance contract or identification number | 5316 | Number of Individuals Covered | 24086 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 074686 |
Policy instance | 5 |
Insurance contract or identification number | 074686 | Number of Individuals Covered | 22228 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $9,035 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 9035 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 887423 |
Policy instance | 4 |
Insurance contract or identification number | 887423 | Number of Individuals Covered | 16 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $3,480 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 3480 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028445 |
Policy instance | 3 |
Insurance contract or identification number | 30028445 | Number of Individuals Covered | 8580 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | 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 number | GTP 9427924 |
Policy instance | 7 |
Insurance contract or identification number | GTP 9427924 | Number of Individuals Covered | 12868 | Insurance policy start date | 2022-04-30 | Insurance policy end date | 2023-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 87240 |
Policy instance | 1 |
Insurance contract or identification number | 87240 | Number of Individuals Covered | 525 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 87240 |
Policy instance | 1 |
Insurance contract or identification number | 87240 | Number of Individuals Covered | 576 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 29316-4 |
Policy instance | 2 |
Insurance contract or identification number | 29316-4 | Number of Individuals Covered | 19778 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $498,037 | Total amount of fees paid to insurance company | USD $364,152 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | INDIVIDUAL EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $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 Broker | USD $417,187 | Additional information about fees paid to insurance broker | WRITING AGENT | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 231678 |
|
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
Policy contract number | 9907-46-29 |
Policy instance | 3 |
Insurance contract or identification number | 9907-46-29 | Number of Individuals Covered | 115 | Insurance policy start date | 2020-10-31 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 30028445 |
Policy instance | 4 |
Insurance contract or identification number | 30028445 | Number of Individuals Covered | 8096 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | 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 number | 887423 |
Policy instance | 5 |
Insurance contract or identification number | 887423 | Number of Individuals Covered | 17 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,385 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $213,479 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,385 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 074686 |
Policy instance | 6 |
Insurance contract or identification number | 074686 | Number of Individuals Covered | 10112 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $7,519 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 7519 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
|
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
Policy contract number | 5316 |
Policy instance | 7 |
Insurance contract or identification number | 5316 | Number of Individuals Covered | 23626 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 number | 29316-4 |
Policy instance | 2 |
Insurance contract or identification number | 29316-4 | Number of Individuals Covered | 20379 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $218,111 | Total amount of fees paid to insurance company | USD $236,547 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | INDIVIDUAL EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 236547 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $155,294 |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 87240 |
Policy instance | 1 |
Insurance contract or identification number | 87240 | Number of Individuals Covered | 6764 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 9907-46-29 |
Policy instance | 3 |
Insurance contract or identification number | 9907-46-29 | Number of Individuals Covered | 115 | Insurance policy start date | 2019-10-31 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 30028445 |
Policy instance | 4 |
Insurance contract or identification number | 30028445 | Number of Individuals Covered | 8462 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | 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 number | 887423 |
Policy instance | 5 |
Insurance contract or identification number | 887423 | Number of Individuals Covered | 27 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 074686 |
Policy instance | 6 |
Insurance contract or identification number | 074686 | Number of Individuals Covered | 10758 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $10,426 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 10426 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
|
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
Policy contract number | 5316 |
Policy instance | 7 |
Insurance contract or identification number | 5316 | Number of Individuals Covered | 24330 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 number | 887423 |
Policy instance | 5 |
Insurance contract or identification number | 887423 | Number of Individuals Covered | 29 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 5316 |
Policy instance | 7 |
Insurance contract or identification number | 5316 | Number of Individuals Covered | 25845 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 number | 9907-46-29 |
Policy instance | 3 |
Insurance contract or identification number | 9907-46-29 | Number of Individuals Covered | 16191 | Insurance policy start date | 2018-10-31 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 87240 |
Policy instance | 1 |
Insurance contract or identification number | 87240 | Number of Individuals Covered | 6812 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 29316-4 |
Policy instance | 2 |
Insurance contract or identification number | 29316-4 | Number of Individuals Covered | 22009 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $222,653 | Total amount of fees paid to insurance company | USD $203,685 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | INDIVIDUAL EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 203685 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $159,284 |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 074686 |
Policy instance | 6 |
Insurance contract or identification number | 074686 | Number of Individuals Covered | 11271 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $14,727 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 14700 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 30028445 |
Policy instance | 4 |
Insurance contract or identification number | 30028445 | Number of Individuals Covered | 8951 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | 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 number | 87240 |
Policy instance | 1 |
Insurance contract or identification number | 87240 | Number of Individuals Covered | 6374 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 900017 |
Policy instance | 4 |
Insurance contract or identification number | 900017 | Number of Individuals Covered | 0 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $-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 number | 074686 |
Policy instance | 7 |
Insurance contract or identification number | 074686 | Number of Individuals Covered | 11318 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $9,531 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 9389 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
|
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
Policy contract number | 5316 |
Policy instance | 8 |
Insurance contract or identification number | 5316 | Number of Individuals Covered | 26237 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $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 number | 887423 |
Policy instance | 6 |
Insurance contract or identification number | 887423 | Number of Individuals Covered | 23 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 30028445 |
Policy instance | 5 |
Insurance contract or identification number | 30028445 | Number of Individuals Covered | 8993 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | 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 number | 9907-46-29 |
Policy instance | 3 |
Insurance contract or identification number | 9907-46-29 | Number of Individuals Covered | 14113 | Insurance policy start date | 2017-10-31 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 29316-4 |
Policy instance | 2 |
Insurance contract or identification number | 29316-4 | Number of Individuals Covered | 21836 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $263,652 | Total amount of fees paid to insurance company | USD $151,020 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | INDIVIDUAL EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $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 Broker | USD $154,445 | Additional information about fees paid to insurance broker | WRITING AGENT | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 151020 |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | B74689/H74686 |
Policy instance | 7 |
Insurance contract or identification number | B74689/H74686 | Number of Individuals Covered | 4031 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 6409 7500 |
Policy instance | 6 |
Insurance contract or identification number | 6409 7500 | Number of Individuals Covered | 14071 | Insurance policy start date | 2016-10-31 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 600690 |
Policy instance | 5 |
Insurance contract or identification number | 600690 | Number of Individuals Covered | 56 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 29316-4 |
Policy instance | 4 |
Insurance contract or identification number | 29316-4 | Number of Individuals Covered | 31607 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $220,427 | Total amount of fees paid to insurance company | USD $101,101 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | INDIVIDUAL EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $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 Broker | USD $154,632 | Additional information about fees paid to insurance broker | WRITING AGENT | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 101101 | Insurance broker name | EOI SERVICE COMPANY, INC. |
|
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | BM1658 |
Policy instance | 3 |
Insurance contract or identification number | BM1658 | Number of Individuals Covered | 156 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 87240 |
Policy instance | 2 |
Insurance contract or identification number | 87240 | Number of Individuals Covered | 5357 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 1034 |
Policy instance | 8 |
Insurance contract or identification number | 1034 | Number of Individuals Covered | 324 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 383 |
Policy instance | 9 |
Insurance contract or identification number | 383 | Number of Individuals Covered | 160 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 100640 |
Policy instance | 10 |
Insurance contract or identification number | 100640 | Number of Individuals Covered | 3 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 900017 |
Policy instance | 11 |
Insurance contract or identification number | 900017 | Number of Individuals Covered | 225 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 30028445 |
Policy instance | 12 |
Insurance contract or identification number | 30028445 | Number of Individuals Covered | 8699 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 100620 |
Policy instance | 13 |
Insurance contract or identification number | 100620 | Number of Individuals Covered | 71 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 180750 |
Policy instance | 14 |
Insurance contract or identification number | 180750 | Number of Individuals Covered | 1 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 887423 |
Policy instance | 15 |
Insurance contract or identification number | 887423 | Number of Individuals Covered | 22 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $187,012 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 074686 |
Policy instance | 16 |
Insurance contract or identification number | 074686 | Number of Individuals Covered | 10610 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 697953 |
Policy instance | 1 |
Insurance contract or identification number | 697953 | Number of Individuals Covered | 4313 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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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