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EXTENSIS HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan NameEXTENSIS HEALTH & WELFARE BENEFIT PLAN
Plan identification number 502

EXTENSIS HEALTH & WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

EXTENSIS HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name:EXTENSIS HOLDINGS, LLC
Employer identification number (EIN):522136196
NAIC Classification:561300

Additional information about EXTENSIS HOLDINGS, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2983931

More information about EXTENSIS HOLDINGS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EXTENSIS HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022015-01-01
5022014-01-01JUDITH THEOBALD
5022013-01-01JUDITH THEOBALD
5022012-01-01RUTH STONE
5022011-01-01GREGORY TUPE
5022010-01-01GREGORY TUPE
5022009-01-01GREGORY TUPE
5022009-01-01GREGORY TUPE

Plan Statistics for EXTENSIS HEALTH & WELFARE BENEFIT PLAN

401k plan membership statisitcs for EXTENSIS HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2015: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0119,031
Total number of active participants reported on line 7a of the Form 55002015-01-0125,423
Total of all active and inactive participants2015-01-0125,423
Total participants2015-01-0125,423
2014: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0115,232
Total number of active participants reported on line 7a of the Form 55002014-01-0119,031
Total of all active and inactive participants2014-01-0119,031
Total participants2014-01-0119,031
2013: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-019,704
Total number of active participants reported on line 7a of the Form 55002013-01-0115,232
Total of all active and inactive participants2013-01-0115,232
Total participants2013-01-0115,232
2012: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-018,380
Total number of active participants reported on line 7a of the Form 55002012-01-019,704
Total of all active and inactive participants2012-01-019,704
Total participants2012-01-019,704
2011: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-016,657
Total number of active participants reported on line 7a of the Form 55002011-01-018,380
Total of all active and inactive participants2011-01-018,380
Total participants2011-01-018,380
2010: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-016,089
Total number of active participants reported on line 7a of the Form 55002010-01-016,657
Total of all active and inactive participants2010-01-016,657
2009: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-015,205
Total number of active participants reported on line 7a of the Form 55002009-01-016,089
Total of all active and inactive participants2009-01-016,089

Form 5500 Responses for EXTENSIS HEALTH & WELFARE BENEFIT PLAN

2015: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: EXTENSIS HEALTH & WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649359
Policy instance 13
Insurance contract or identification number649359
Number of Individuals Covered80
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number212091
Policy instance 3
Insurance contract or identification number212091
Number of Individuals Covered6845
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $34,155
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $341,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,155
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number811307
Policy instance 1
Insurance contract or identification number811307
Number of Individuals Covered12074
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $593,082
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $51,137,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $560,719
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP INC
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number96672
Policy instance 2
Insurance contract or identification number96672
Number of Individuals Covered649
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,130
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $144,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,130
Insurance broker organization code?3
Insurance broker nameNIP GROUP, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE446952
Policy instance 4
Insurance contract or identification numberAE446952
Number of Individuals Covered5
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Welfare Benefit Premiums Paid to CarrierUSD $16,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649357
Policy instance 5
Insurance contract or identification number649357
Number of Individuals Covered1488
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649358
Policy instance 6
Insurance contract or identification number649358
Number of Individuals Covered1762
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649360
Policy instance 7
Insurance contract or identification number649360
Number of Individuals Covered1746
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649752
Policy instance 12
Insurance contract or identification number649752
Number of Individuals Covered4
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 )
Policy contract number0811307HNO
Policy instance 11
Insurance contract or identification number0811307HNO
Number of Individuals Covered868
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Welfare Benefit Premiums Paid to CarrierUSD $2,913,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameNIP GROUP
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649410
Policy instance 10
Insurance contract or identification number649410
Number of Individuals Covered71
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649356
Policy instance 9
Insurance contract or identification number649356
Number of Individuals Covered2028
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649361
Policy instance 8
Insurance contract or identification number649361
Number of Individuals Covered1633
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649358
Policy instance 7
Insurance contract or identification number649358
Number of Individuals Covered21
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $433
Temporary Disability 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 $433
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649357
Policy instance 6
Insurance contract or identification number649357
Number of Individuals Covered205
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,458
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,458
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE446952
Policy instance 5
Insurance contract or identification numberAE446952
Number of Individuals Covered5
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Welfare Benefit Premiums Paid to CarrierUSD $16,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number212091
Policy instance 4
Insurance contract or identification number212091
Number of Individuals Covered2420
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $24,395
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $243,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,395
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649361
Policy instance 9
Insurance contract or identification number649361
Number of Individuals Covered68
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,248
Temporary Disability 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 $1,248
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number811307
Policy instance 2
Insurance contract or identification number811307
Number of Individuals Covered9561
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $159,939
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $38,502,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $159,939
Insurance broker organization code?3
Insurance broker nameNIP GROUP
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE438381
Policy instance 1
Insurance contract or identification numberAE438381
Number of Individuals Covered3
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Welfare Benefit Premiums Paid to CarrierUSD $1,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649356
Policy instance 10
Insurance contract or identification number649356
Number of Individuals Covered35
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $534
Temporary Disability 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 $534
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649410
Policy instance 11
Insurance contract or identification number649410
Number of Individuals Covered14
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $172
Temporary Disability 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 $172
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 )
Policy contract number0811307HNO
Policy instance 12
Insurance contract or identification number0811307HNO
Number of Individuals Covered222
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $14,405
Welfare Benefit Premiums Paid to CarrierUSD $668,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,189
Insurance broker nameNIP GROUP
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number96672
Policy instance 3
Insurance contract or identification number96672
Number of Individuals Covered620
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,956
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $132,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,956
Insurance broker organization code?3
Insurance broker nameNIP GROUP, INC.
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649360
Policy instance 8
Insurance contract or identification number649360
Number of Individuals Covered111
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,177
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,177
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number811307
Policy instance 2
Insurance contract or identification number811307
Number of Individuals Covered7807
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $274,081
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $28,843,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $272,043
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP, INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649356
Policy instance 12
Insurance contract or identification number649356
Number of Individuals Covered16
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $200
Temporary Disability 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 $200
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE438381
Policy instance 1
Insurance contract or identification numberAE438381
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Welfare Benefit Premiums Paid to CarrierUSD $4,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number96672
Policy instance 3
Insurance contract or identification number96672
Number of Individuals Covered562
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,737
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $122,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,737
Insurance broker organization code?3
Insurance broker nameNIP GROUP, INC.
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number212091
Policy instance 4
Insurance contract or identification number212091
Number of Individuals Covered3599
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $18,407
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $184,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,514
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE446952
Policy instance 5
Insurance contract or identification numberAE446952
Number of Individuals Covered5
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Welfare Benefit Premiums Paid to CarrierUSD $14,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649356
Policy instance 6
Insurance contract or identification number649356
Number of Individuals Covered2044
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $32,447
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,447
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649357
Policy instance 7
Insurance contract or identification number649357
Number of Individuals Covered506
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $8,747
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,747
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649358
Policy instance 8
Insurance contract or identification number649358
Number of Individuals Covered1607
Insurance policy start date2013-01-01
Insurance policy end date2013-12-01
Total amount of commissions paid to insurance brokerUSD $28,848
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,848
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number649359
Policy instance 9
Insurance contract or identification number649359
Number of Individuals Covered51
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,116
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,116
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649360
Policy instance 10
Insurance contract or identification number649360
Number of Individuals Covered399
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $544
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $544
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number649361
Policy instance 11
Insurance contract or identification number649361
Number of Individuals Covered1781
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,210
Unemployment 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 $2,210
Insurance broker organization code?3
Insurance broker nameNIP GROUP INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number811307
Policy instance 2
Insurance contract or identification number811307
Number of Individuals Covered6764
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $112,064
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,176,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $105,253
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP, INC.
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number96672
Policy instance 3
Insurance contract or identification number96672
Number of Individuals Covered544
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,507
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,507
Insurance broker organization code?3
Insurance broker nameNIP GROUP, INC. D/B/A MARQUIS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number212091
Policy instance 4
Insurance contract or identification number212091
Number of Individuals Covered1514
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $15,899
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $146,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,899
Insurance broker organization code?3
Insurance broker nameALBIEZ INS AGENCY
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE446952
Policy instance 5
Insurance contract or identification numberAE446952
Number of Individuals Covered4
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Welfare Benefit Premiums Paid to CarrierUSD $12,966
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 numberAE438381
Policy instance 1
Insurance contract or identification numberAE438381
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Welfare Benefit Premiums Paid to CarrierUSD $4,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number096672
Policy instance 3
Insurance contract or identification number096672
Number of Individuals Covered517
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,744
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $125,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number212091
Policy instance 4
Insurance contract or identification number212091
Number of Individuals Covered1291
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $13,678
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $136,784
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 number811307
Policy instance 2
Insurance contract or identification number811307
Number of Individuals Covered6413
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $1,005,054
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $24,968,083
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 numberAE438381
Policy instance 1
Insurance contract or identification numberAE438381
Number of Individuals Covered3
Insurance policy start date2011-06-01
Insurance policy end date2011-12-31
Welfare Benefit Premiums Paid to CarrierUSD $5,427
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 number800544
Policy instance 4
Insurance contract or identification number800544
Number of Individuals Covered38
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,437
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 number811307
Policy instance 3
Insurance contract or identification number811307
Number of Individuals Covered4136
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $729,444
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $22,790,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $729,444
Insurance broker organization code?3
Insurance broker nameNIP GROUP
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number212091
Policy instance 1
Insurance contract or identification number212091
Number of Individuals Covered1141
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $11,279
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,279
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameALBIEZ INSURANCE AGENCY
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number096672
Policy instance 2
Insurance contract or identification number096672
Number of Individuals Covered515
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,143
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,143
Insurance broker organization code?3
Insurance broker nameALBIEZ INSURANCE AGENCY

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