EXTENSIS HOLDINGS, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EXTENSIS HEALTH & WELFARE BENEFIT PLAN
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649359 |
Policy instance | 13 |
Insurance contract or identification number | 649359 | Number of Individuals Covered | 80 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 212091 |
Policy instance | 3 |
Insurance contract or identification number | 212091 | Number of Individuals Covered | 6845 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $34,155 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $341,559 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,155 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 811307 |
Policy instance | 1 |
Insurance contract or identification number | 811307 | Number of Individuals Covered | 12074 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-10-31 | Total amount of commissions paid to insurance broker | USD $593,082 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 Broker | USD $560,719 | Insurance broker organization code? | 3 | Insurance broker name | COMPASS CONSULTING GROUP INC |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 96672 |
Policy instance | 2 |
Insurance contract or identification number | 96672 | Number of Individuals Covered | 649 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $5,130 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $144,370 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,130 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP, INC. |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE446952 |
Policy instance | 4 |
Insurance contract or identification number | AE446952 | Number of Individuals Covered | 5 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $16,964 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649357 |
Policy instance | 5 |
Insurance contract or identification number | 649357 | Number of Individuals Covered | 1488 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | STATE 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 name | NIP GROUP INC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649358 |
Policy instance | 6 |
Insurance contract or identification number | 649358 | Number of Individuals Covered | 1762 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | 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 name | NIP GROUP INC |
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THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649360 |
Policy instance | 7 |
Insurance contract or identification number | 649360 | Number of Individuals Covered | 1746 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | STATE 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 name | NIP GROUP INC |
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THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649752 |
Policy instance | 12 |
Insurance contract or identification number | 649752 | Number of Individuals Covered | 4 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
Policy contract number | 0811307HNO |
Policy instance | 11 |
Insurance contract or identification number | 0811307HNO | Number of Individuals Covered | 868 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-10-31 | Welfare Benefit Premiums Paid to Carrier | USD $2,913,609 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker name | NIP GROUP |
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THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649410 |
Policy instance | 10 |
Insurance contract or identification number | 649410 | Number of Individuals Covered | 71 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | 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 name | NIP GROUP INC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649356 |
Policy instance | 9 |
Insurance contract or identification number | 649356 | Number of Individuals Covered | 2028 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | 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 name | NIP GROUP INC |
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THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649361 |
Policy instance | 8 |
Insurance contract or identification number | 649361 | Number of Individuals Covered | 1633 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | 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 name | NIP GROUP INC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649358 |
Policy instance | 7 |
Insurance contract or identification number | 649358 | Number of Individuals Covered | 21 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $433 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $433 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649357 |
Policy instance | 6 |
Insurance contract or identification number | 649357 | Number of Individuals Covered | 205 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $2,458 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | STATE DISABILITY | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,458 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE446952 |
Policy instance | 5 |
Insurance contract or identification number | AE446952 | Number of Individuals Covered | 5 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $16,781 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 212091 |
Policy instance | 4 |
Insurance contract or identification number | 212091 | Number of Individuals Covered | 2420 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $24,395 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $243,946 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,395 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649361 |
Policy instance | 9 |
Insurance contract or identification number | 649361 | Number of Individuals Covered | 68 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $1,248 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,248 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 811307 |
Policy instance | 2 |
Insurance contract or identification number | 811307 | Number of Individuals Covered | 9561 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $159,939 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 Broker | USD $159,939 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE438381 |
Policy instance | 1 |
Insurance contract or identification number | AE438381 | Number of Individuals Covered | 3 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-03-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,098 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649356 |
Policy instance | 10 |
Insurance contract or identification number | 649356 | Number of Individuals Covered | 35 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $534 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $534 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649410 |
Policy instance | 11 |
Insurance contract or identification number | 649410 | Number of Individuals Covered | 14 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $172 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $172 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
Policy contract number | 0811307HNO |
Policy instance | 12 |
Insurance contract or identification number | 0811307HNO | Number of Individuals Covered | 222 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $14,405 | Welfare Benefit Premiums Paid to Carrier | USD $668,133 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,189 | Insurance broker name | NIP GROUP |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 96672 |
Policy instance | 3 |
Insurance contract or identification number | 96672 | Number of Individuals Covered | 620 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $4,956 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $132,758 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,956 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP, INC. |
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THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649360 |
Policy instance | 8 |
Insurance contract or identification number | 649360 | Number of Individuals Covered | 111 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $2,177 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | STATE DISABILITY | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,177 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 811307 |
Policy instance | 2 |
Insurance contract or identification number | 811307 | Number of Individuals Covered | 7807 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $274,081 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 Broker | USD $272,043 | Insurance broker organization code? | 3 | Insurance broker name | COMPASS CONSULTING GROUP, INC. |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649356 |
Policy instance | 12 |
Insurance contract or identification number | 649356 | Number of Individuals Covered | 16 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $200 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $200 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE438381 |
Policy instance | 1 |
Insurance contract or identification number | AE438381 | Number of Individuals Covered | 3 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $4,053 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 96672 |
Policy instance | 3 |
Insurance contract or identification number | 96672 | Number of Individuals Covered | 562 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,737 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $122,378 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,737 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP, INC. |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 212091 |
Policy instance | 4 |
Insurance contract or identification number | 212091 | Number of Individuals Covered | 3599 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $18,407 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $184,068 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,514 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE446952 |
Policy instance | 5 |
Insurance contract or identification number | AE446952 | Number of Individuals Covered | 5 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $14,497 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649356 |
Policy instance | 6 |
Insurance contract or identification number | 649356 | Number of Individuals Covered | 2044 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $32,447 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | STATE DISABILITY | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,447 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649357 |
Policy instance | 7 |
Insurance contract or identification number | 649357 | Number of Individuals Covered | 506 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $8,747 | Other welfare benefits provided | STATE DISABILITY | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,747 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649358 |
Policy instance | 8 |
Insurance contract or identification number | 649358 | Number of Individuals Covered | 1607 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-01 | Total amount of commissions paid to insurance broker | USD $28,848 | Other welfare benefits provided | STATE DISABILITY | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,848 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 649359 |
Policy instance | 9 |
Insurance contract or identification number | 649359 | Number of Individuals Covered | 51 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $1,116 | Other welfare benefits provided | STATE DISABILITY | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,116 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649360 |
Policy instance | 10 |
Insurance contract or identification number | 649360 | Number of Individuals Covered | 399 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $544 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | STATE DISABILITY | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $544 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 ) |
Policy contract number | 649361 |
Policy instance | 11 |
Insurance contract or identification number | 649361 | Number of Individuals Covered | 1781 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $2,210 | Unemployment Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,210 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 811307 |
Policy instance | 2 |
Insurance contract or identification number | 811307 | Number of Individuals Covered | 6764 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $112,064 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 Broker | USD $105,253 | Insurance broker organization code? | 3 | Insurance broker name | COMPASS CONSULTING GROUP, INC. |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 96672 |
Policy instance | 3 |
Insurance contract or identification number | 96672 | Number of Individuals Covered | 544 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,507 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $107,551 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,507 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP, INC. D/B/A MARQUIS |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 212091 |
Policy instance | 4 |
Insurance contract or identification number | 212091 | Number of Individuals Covered | 1514 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $15,899 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $146,442 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,899 | Insurance broker organization code? | 3 | Insurance broker name | ALBIEZ INS AGENCY |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE446952 |
Policy instance | 5 |
Insurance contract or identification number | AE446952 | Number of Individuals Covered | 4 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $12,966 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE438381 |
Policy instance | 1 |
Insurance contract or identification number | AE438381 | Number of Individuals Covered | 3 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $4,055 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 096672 |
Policy instance | 3 |
Insurance contract or identification number | 096672 | Number of Individuals Covered | 517 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,744 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $125,198 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 212091 |
Policy instance | 4 |
Insurance contract or identification number | 212091 | Number of Individuals Covered | 1291 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $13,678 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $136,784 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 811307 |
Policy instance | 2 |
Insurance contract or identification number | 811307 | Number of Individuals Covered | 6413 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $1,005,054 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $24,968,083 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | AE438381 |
Policy instance | 1 |
Insurance contract or identification number | AE438381 | Number of Individuals Covered | 3 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2011-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $5,427 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 800544 |
Policy instance | 4 |
Insurance contract or identification number | 800544 | Number of Individuals Covered | 38 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $89,437 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 811307 |
Policy instance | 3 |
Insurance contract or identification number | 811307 | Number of Individuals Covered | 4136 | Insurance policy start date | 2009-11-01 | Insurance policy end date | 2010-10-31 | Total amount of commissions paid to insurance broker | USD $729,444 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 Broker | USD $729,444 | Insurance broker organization code? | 3 | Insurance broker name | NIP GROUP |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 212091 |
Policy instance | 1 |
Insurance contract or identification number | 212091 | Number of Individuals Covered | 1141 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $11,279 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $112,793 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,279 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ALBIEZ INSURANCE AGENCY |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 096672 |
Policy instance | 2 |
Insurance contract or identification number | 096672 | Number of Individuals Covered | 515 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $4,143 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $97,683 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,143 | Insurance broker organization code? | 3 | Insurance broker name | ALBIEZ INSURANCE AGENCY |
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