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EAGLE GROUP HEALTH PLAN 401k Plan overview

Plan NameEAGLE GROUP HEALTH PLAN
Plan identification number 501

EAGLE GROUP HEALTH PLAN 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

401k Sponsoring company profile

METAL MASTERS FOODSERVICE EQUIPMENT has sponsored the creation of one or more 401k plans.

Company Name:METAL MASTERS FOODSERVICE EQUIPMENT
Employer identification number (EIN):521119794
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EAGLE GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01DARKO ORSIC DARKO ORSIC2018-10-05
5012016-01-01DARKO ORSIC DARKO ORSIC2017-10-16
5012015-01-01RANDOLPH A. FOX RANDOLPH A. FOX2016-08-25
5012014-01-01RANDOLPH A. FOX RANDOLPH A. FOX2015-10-15
5012013-01-01RANDOLPH A. FOX RANDOLPH A. FOX2015-10-15
5012012-04-01RANDOLPH A. FOX RANDOLPH A. FOX2013-10-10
5012011-04-01RANDOLPH FOX RANDOLPH FOX2013-01-11
5012010-04-01RANDOLPH FOX
5012009-04-01 RANDOLPH FOX2010-10-29
5012009-04-01 RANDOLPH FOX2010-10-28
5012009-04-01RANDOLPH FOX
5012009-04-01 RANDOLPH FOX2010-10-27

Plan Statistics for EAGLE GROUP HEALTH PLAN

401k plan membership statisitcs for EAGLE GROUP HEALTH PLAN

Measure Date Value
2022: EAGLE GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01303
Total number of active participants reported on line 7a of the Form 55002022-01-01308
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01308
2021: EAGLE GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01313
Total number of active participants reported on line 7a of the Form 55002021-01-01303
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01303
2020: EAGLE GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01344
Total number of active participants reported on line 7a of the Form 55002020-01-01313
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01313
2019: EAGLE GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01348
Total number of active participants reported on line 7a of the Form 55002019-01-01344
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01344
2018: EAGLE GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01331
Total number of active participants reported on line 7a of the Form 55002018-01-01348
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01348
2017: EAGLE GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01323
Total number of active participants reported on line 7a of the Form 55002017-01-01331
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01331
2016: EAGLE GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01324
Total number of active participants reported on line 7a of the Form 55002016-01-01323
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01323
2015: EAGLE GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01320
Total number of active participants reported on line 7a of the Form 55002015-01-01324
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01324
2014: EAGLE GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01306
Total number of active participants reported on line 7a of the Form 55002014-01-01320
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01320
2013: EAGLE GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01309
Total number of active participants reported on line 7a of the Form 55002013-01-01306
Total of all active and inactive participants2013-01-01306
2012: EAGLE GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01308
Total number of active participants reported on line 7a of the Form 55002012-04-01309
Total of all active and inactive participants2012-04-01309
2011: EAGLE GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01292
Total number of active participants reported on line 7a of the Form 55002011-04-01308
Total of all active and inactive participants2011-04-01308
Total participants2011-04-01308
2010: EAGLE GROUP HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-04-01303
Total number of active participants reported on line 7a of the Form 55002010-04-01292
Total of all active and inactive participants2010-04-01292
Total participants2010-04-01292
2009: EAGLE GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01323
Total number of active participants reported on line 7a of the Form 55002009-04-01303
Total of all active and inactive participants2009-04-01303
Total participants2009-04-01303

Financial Data on EAGLE GROUP HEALTH PLAN

Measure Date Value
2022 : EAGLE GROUP HEALTH PLAN 2022 401k financial data
Total income from all sources (including contributions)2022-12-31$5,333,306
Total of all expenses incurred2022-12-31$5,333,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$5,186,581
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$5,333,306
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$146,725
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$1,575
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$750,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,545,642
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$2,457
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 assets at end of year (total assets less liabilities)2022-12-31$0
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
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$269,441
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
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$3,785,207
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$4,917,140
Contract administrator fees2022-12-31$145,150
Did the plan have assets held for investment2022-12-31No
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
2021 : EAGLE GROUP HEALTH PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-12-31$5,300,660
Total of all expenses incurred2021-12-31$5,300,660
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$5,155,671
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$5,300,660
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$144,989
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$1,650
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$750,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,589,816
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$7,132
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 assets at end of year (total assets less liabilities)2021-12-31$0
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
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$252,511
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
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$3,703,712
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$4,903,160
Contract administrator fees2021-12-31$143,339
Did the plan have assets held for investment2021-12-31No
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
2020 : EAGLE GROUP HEALTH PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-12-31$4,826,230
Total of all expenses incurred2020-12-31$4,826,230
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$4,660,140
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$4,826,230
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$166,090
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$1,400
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$750,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,635,549
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$9,137
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 assets at end of year (total assets less liabilities)2020-12-31$0
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
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$250,095
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
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$3,181,544
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$4,410,045
Contract administrator fees2020-12-31$164,690
Did the plan have assets held for investment2020-12-31No
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
2019 : EAGLE GROUP HEALTH PLAN 2019 401k financial data
Total income from all sources (including contributions)2019-12-31$5,972,280
Total of all expenses incurred2019-12-31$5,972,280
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$5,805,944
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$5,972,280
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$166,336
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$1,845
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$750,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,610,489
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$8,633
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 assets at end of year (total assets less liabilities)2019-12-31$0
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
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$249,585
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
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$4,353,158
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$5,556,359
Contract administrator fees2019-12-31$164,491
Did the plan have assets held for investment2019-12-31No
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
2018 : EAGLE GROUP HEALTH PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-12-31$4,864,884
Total of all expenses incurred2018-12-31$4,864,884
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$4,724,151
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$4,864,884
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$140,733
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$1,175
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$750,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,412,553
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$18,556
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 assets at end of year (total assets less liabilities)2018-12-31$0
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
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$248,675
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
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$3,433,775
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$4,475,476
Contract administrator fees2018-12-31$139,558
Did the plan have assets held for investment2018-12-31No
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
2017 : EAGLE GROUP HEALTH PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$4,518,245
Total of all expenses incurred2017-12-31$4,518,245
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$4,268,417
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$4,518,245
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$249,828
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$1,950
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$750,000
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$1,296,770
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$2,936
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 assets at end of year (total assets less liabilities)2017-12-31$0
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
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$4,019,033
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
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$3,218,539
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$249,384
Contract administrator fees2017-12-31$247,878
Did the plan have assets held for investment2017-12-31No
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
2016 : EAGLE GROUP HEALTH PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$4,676,600
Total of all expenses incurred2016-12-31$4,676,600
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$4,455,465
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$4,676,600
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$221,135
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$1,605
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$750,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,262,765
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$7,095
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net assets at end of year (total assets less liabilities)2016-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$4,221,927
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$3,406,740
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$233,538
Contract administrator fees2016-12-31$219,530
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
2015 : EAGLE GROUP HEALTH PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$4,244,999
Total of all expenses incurred2015-12-31$4,244,999
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$3,917,439
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$4,244,999
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$327,560
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$1,665
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$750,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,215,272
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$6,083
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net assets at end of year (total assets less liabilities)2015-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$3,689,363
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$3,023,644
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$228,076
Contract administrator fees2015-12-31$325,895
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
2014 : EAGLE GROUP HEALTH PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$4,428,720
Total of all expenses incurred2014-12-31$4,428,720
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$4,227,317
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$4,428,720
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$201,403
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$750,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,098,039
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$7,687
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net assets at end of year (total assets less liabilities)2014-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$4,009,019
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$3,322,994
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$218,298
Contract administrator fees2014-12-31$201,403
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
2013 : EAGLE GROUP HEALTH PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-12-31$3,388,573
Total of all expenses incurred2013-12-31$3,388,573
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$3,264,887
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$3,388,573
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$123,686
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$750,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$937,584
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$19,509
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net assets at end of year (total assets less liabilities)2013-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$3,057,613
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$2,431,480
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$207,274
Contract administrator fees2013-12-31$123,686
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
2012 : EAGLE GROUP HEALTH PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$2,339,537
Total of all expenses incurred2012-12-31$2,339,537
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$2,220,245
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$2,339,537
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$119,292
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$750,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$689,541
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$11,568
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net assets at end of year (total assets less liabilities)2012-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$2,080,831
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,638,428
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$139,414
Contract administrator fees2012-12-31$119,292
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Total income from all sources (including contributions)2012-03-31$3,161,399
Total of all expenses incurred2012-03-31$3,161,399
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-03-31$3,025,000
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-03-31$3,161,399
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-03-31$136,399
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-03-31No
Administrative expenses professional fees incurred2012-03-31$490
Was this plan covered by a fidelity bond2012-03-31Yes
Value of fidelity bond cover2012-03-31$750,000
If this is an individual account plan, was there a blackout period2012-03-31No
Were there any nonexempt tranactions with any party-in-interest2012-03-31No
Contributions received from participants2012-03-31$926,121
Income. Received or receivable in cash from other sources (including rollovers)2012-03-31$12,185
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Value of net income/loss2012-03-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-03-31No
Were any leases to which the plan was party in default or uncollectible2012-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-03-31$2,844,526
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-03-31No
Was there a failure to transmit to the plan any participant contributions2012-03-31No
Has the plan failed to provide any benefit when due under the plan2012-03-31No
Contributions received in cash from employer2012-03-31$2,223,093
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-03-31$180,474
Contract administrator fees2012-03-31$135,909
Did the plan have assets held for investment2012-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-03-31No
2011 : EAGLE GROUP HEALTH PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-03-31$3,061,011
Total of all expenses incurred2011-03-31$3,061,011
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-03-31$2,920,486
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-03-31$3,061,011
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-03-31$140,525
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-03-31No
Administrative expenses professional fees incurred2011-03-31$775
Was this plan covered by a fidelity bond2011-03-31Yes
Value of fidelity bond cover2011-03-31$750,000
If this is an individual account plan, was there a blackout period2011-03-31No
Were there any nonexempt tranactions with any party-in-interest2011-03-31No
Contributions received from participants2011-03-31$748,687
Income. Received or receivable in cash from other sources (including rollovers)2011-03-31$10,255
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Value of net income/loss2011-03-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-03-31No
Were any leases to which the plan was party in default or uncollectible2011-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2011-03-31$2,740,348
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-03-31No
Was there a failure to transmit to the plan any participant contributions2011-03-31No
Has the plan failed to provide any benefit when due under the plan2011-03-31No
Contributions received in cash from employer2011-03-31$2,302,069
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-03-31$180,138
Contract administrator fees2011-03-31$139,750
Did the plan have assets held for investment2011-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-03-31No

Form 5500 Responses for EAGLE GROUP HEALTH PLAN

2022: EAGLE GROUP HEALTH PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: EAGLE GROUP HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: EAGLE GROUP HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: EAGLE GROUP HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: EAGLE GROUP HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: EAGLE GROUP HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: EAGLE GROUP HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: EAGLE GROUP HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: EAGLE GROUP HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: EAGLE GROUP HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: EAGLE GROUP HEALTH PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan funding arrangement – General assets of the sponsorYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – General assets of the sponsorYes
2011: EAGLE GROUP HEALTH PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan funding arrangement – General assets of the sponsorYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – General assets of the sponsorYes
2010: EAGLE GROUP HEALTH PLAN 2010 form 5500 responses
2010-04-01Type of plan entitySingle employer plan
2010-04-01Submission has been amendedYes
2010-04-01This submission is the final filingNo
2010-04-01This return/report is a short plan year return/report (less than 12 months)No
2010-04-01Plan is a collectively bargained planNo
2010-04-01Plan funding arrangement – InsuranceYes
2010-04-01Plan funding arrangement – General assets of the sponsorYes
2010-04-01Plan benefit arrangement – InsuranceYes
2010-04-01Plan benefit arrangement – General assets of the sponsorYes
2009: EAGLE GROUP HEALTH PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedYes
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan funding arrangement – General assets of the sponsorYes
2009-04-01Plan benefit arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 2
Insurance contract or identification number886867G
Number of Individuals Covered409
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,110
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,110
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number108644
Policy instance 6
Insurance contract or identification number108644
Number of Individuals Covered308
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $44,580
Total amount of fees paid to insurance companyUSD $100,570
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $681,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,580
Amount paid for insurance broker fees100570
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 5
Insurance contract or identification number886867G
Number of Individuals Covered138
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 4
Insurance contract or identification number886867G
Number of Individuals Covered127
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 3
Insurance contract or identification number886867G
Number of Individuals Covered140
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 1
Insurance contract or identification number886867G
Number of Individuals Covered409
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $12,180
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $7,075
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,180
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HEALTHJOY, LLC (National Association of Insurance Commissioners NAIC id number: 51121 )
Policy contract number
Policy instance 7
Number of Individuals Covered427
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Other welfare benefits providedBEHAVIORAL HEALTH
Welfare Benefit Premiums Paid to CarrierUSD $7,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 2
Insurance contract or identification number886867G
Number of Individuals Covered412
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,237
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,237
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 1
Insurance contract or identification number886867G
Number of Individuals Covered412
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $12,184
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,184
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 3
Insurance contract or identification number886867G
Number of Individuals Covered154
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 4
Insurance contract or identification number886867G
Number of Individuals Covered143
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 5
Insurance contract or identification number886867G
Number of Individuals Covered141
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,881
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number108644
Policy instance 6
Insurance contract or identification number108644
Number of Individuals Covered303
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $44,676
Total amount of fees paid to insurance companyUSD $83,241
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,676
Amount paid for insurance broker fees83241
Additional information about fees paid to insurance brokerAGENT OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 1
Insurance contract or identification number886867G
Number of Individuals Covered387
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,823
Total amount of fees paid to insurance companyUSD $5,195
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,720
Amount paid for insurance broker fees5195
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 2
Insurance contract or identification number886867G
Number of Individuals Covered387
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,721
Total amount of fees paid to insurance companyUSD $1,438
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,438
Amount paid for insurance broker fees1438
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 3
Insurance contract or identification number886867G
Number of Individuals Covered171
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 4
Insurance contract or identification number886867G
Number of Individuals Covered161
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 5
Insurance contract or identification number886867G
Number of Individuals Covered141
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,409
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 number108644
Policy instance 6
Insurance contract or identification number108644
Number of Individuals Covered313
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $47,220
Total amount of fees paid to insurance companyUSD $103,294
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,220
Amount paid for insurance broker fees103294
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number108644
Policy instance 6
Insurance contract or identification number108644
Number of Individuals Covered344
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $51,768
Total amount of fees paid to insurance companyUSD $96,967
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,768
Amount paid for insurance broker fees96967
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 4
Insurance contract or identification number886867G
Number of Individuals Covered172
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 3
Insurance contract or identification number886867G
Number of Individuals Covered176
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 2
Insurance contract or identification number886867G
Number of Individuals Covered425
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,689
Total amount of fees paid to insurance companyUSD $1,689
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,689
Amount paid for insurance broker fees1689
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 1
Insurance contract or identification number886867G
Number of Individuals Covered425
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,853
Total amount of fees paid to insurance companyUSD $6,525
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,853
Amount paid for insurance broker fees6525
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886867G
Policy instance 5
Insurance contract or identification number886867G
Number of Individuals Covered154
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AKM4
Policy instance 4
Insurance contract or identification numberG000AKM4
Number of Individuals Covered449
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of fees paid to insurance companyUSD $446
Temporary Disability 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 fees446
Additional information about fees paid to insurance brokerOTHER COMPENSATION
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AKM4
Policy instance 3
Insurance contract or identification numberGLUG0AKM4
Number of Individuals Covered450
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,983
Total amount of fees paid to insurance companyUSD $3,206
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $58,187
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,413
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
Amount paid for insurance broker fees3206
BLUE CROSS BLUE SHIELD OF DELAWARE, INC. (National Association of Insurance Commissioners NAIC id number: 53287 )
Policy contract number124090
Policy instance 2
Insurance contract or identification number124090
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $45,903
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,254
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AKM4
Policy instance 1
Insurance contract or identification numberGLTD0AKM4
Number of Individuals Covered152
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,631
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,239
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AKM4
Policy instance 5
Insurance contract or identification numberG000AKM4
Number of Individuals Covered130
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,913
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,132
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,425
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AKM4
Policy instance 3
Insurance contract or identification numberGLUG0AKM4
Number of Individuals Covered392
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,680
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $55,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,680
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameDOVER FINANCIAL GROUP
BLUE CROSS BLUE SHIELD OF DELAWARE, INC. (National Association of Insurance Commissioners NAIC id number: 53287 )
Policy contract number124090
Policy instance 2
Insurance contract or identification number124090
Number of Individuals Covered606
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $44,034
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,034
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AKM4
Policy instance 1
Insurance contract or identification numberGLTD0AKM4
Number of Individuals Covered148
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,544
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,544
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameDOVER FINANCIAL GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AKM4
Policy instance 1
Insurance contract or identification numberGLTD0AKM4
Number of Individuals Covered125
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,132
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,132
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
BLUE CROSS BLUE SHIELD OF DELAWARE, INC. (National Association of Insurance Commissioners NAIC id number: 53287 )
Policy contract number124090
Policy instance 2
Insurance contract or identification number124090
Number of Individuals Covered606
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $35,435
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,435
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AKM4
Policy instance 3
Insurance contract or identification numberGLUG0AKM4
Number of Individuals Covered354
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,359
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $44,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,359
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AKM4
Policy instance 1
Insurance contract or identification numberGLTD0AKM4
Number of Individuals Covered125
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,017
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,017
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
BLUE CROSS BLUE SHIELD OF DELAWARE, INC. (National Association of Insurance Commissioners NAIC id number: 53287 )
Policy contract number124090
Policy instance 2
Insurance contract or identification number124090
Number of Individuals Covered606
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $29,440
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,440
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AKM4
Policy instance 3
Insurance contract or identification numberGLUG0AKM4
Number of Individuals Covered358
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,409
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $36,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,409
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AKM4
Policy instance 3
Insurance contract or identification numberGLUG0AKM4
Number of Individuals Covered331
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,955
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $32,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,955
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AKM4
Policy instance 1
Insurance contract or identification numberGLTD0AKM4
Number of Individuals Covered110
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,641
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,641
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
BLUE CROSS BLUE SHIELD OF DELAWARE, INC. (National Association of Insurance Commissioners NAIC id number: 53287 )
Policy contract number124090
Policy instance 2
Insurance contract or identification number124090
Number of Individuals Covered604
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,416
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,416
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
BLUE CROSS BLUE SHIELD OF DELAWARE, INC. (National Association of Insurance Commissioners NAIC id number: 53287 )
Policy contract number124090
Policy instance 2
Insurance contract or identification number124090
Number of Individuals Covered582
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $21,654
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $176,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,654
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AKM4
Policy instance 3
Insurance contract or identification numberGLUG0AKM4
Number of Individuals Covered348
Insurance policy start date2012-01-01
Insurance policy end date2013-01-01
Total amount of commissions paid to insurance brokerUSD $4,004
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $33,368
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,004
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AKM4
Policy instance 1
Insurance contract or identification numberGLTD0AKM4
Number of Individuals Covered115
Insurance policy start date2012-01-01
Insurance policy end date2013-01-01
Total amount of commissions paid to insurance brokerUSD $2,674
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,674
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker nameDOVER FINANCIAL GROUP
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number864370G
Policy instance 1
Insurance contract or identification number864370G
Number of Individuals Covered120
Insurance policy start date2011-01-01
Insurance policy end date2012-01-01
Total amount of commissions paid to insurance brokerUSD $2,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number864370G
Policy instance 3
Insurance contract or identification number864370G
Number of Individuals Covered341
Insurance policy start date2011-01-01
Insurance policy end date2012-01-01
Total amount of commissions paid to insurance brokerUSD $4,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 )
Policy contract numberIOA146297-09
Policy instance 2
Insurance contract or identification numberIOA146297-09
Number of Individuals Covered288
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $7,483
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
AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 )
Policy contract numberIOA146297-09
Policy instance 2
Insurance contract or identification numberIOA146297-09
Number of Individuals Covered292
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $8,714
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $8,714
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameBROKERAGE CONCEPTS, INC.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number864370G
Policy instance 1
Insurance contract or identification number864370G
Number of Individuals Covered339
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $4,634
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $4,634
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameDOVER FINANCIAL GROUP
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number864370G
Policy instance 3
Insurance contract or identification number864370G
Number of Individuals Covered122
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $2,344
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $2,344
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameDOVER FINANCIAL GROUP

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