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GLOBAL WIRELESS SOLUTIONS, INC. 401k Plan overview

Plan NameGLOBAL WIRELESS SOLUTIONS, INC.
Plan identification number 502

GLOBAL WIRELESS SOLUTIONS, INC. Benefits

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

401k Sponsoring company profile

GLOBAL WIRELESS SOLUTIONS, INC. has sponsored the creation of one or more 401k plans.

Company Name:GLOBAL WIRELESS SOLUTIONS, INC.
Employer identification number (EIN):541813528
NAIC Classification:541519
NAIC Description:Other Computer Related Services

Additional information about GLOBAL WIRELESS SOLUTIONS, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1998-07-30
Company Identification Number: 2284070
Legal Registered Office Address: 112 NEWTON ROAD
Nassau
PLAINVIEW
United States of America (USA)
11803

More information about GLOBAL WIRELESS SOLUTIONS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GLOBAL WIRELESS SOLUTIONS, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-07-01JILL OBANDO2023-03-02
5022020-07-01JILL OBANDO2023-02-15
5022019-07-01JILL OBANDO2020-10-28
5022018-07-01JILL OBANDO2020-01-27
5022017-07-01
5022016-07-01
5022015-07-01
5022014-07-01
5022013-07-01
5022012-07-01JILL OBANDO
5022011-07-01JILL OBANDO
5022010-07-01JILL OBANDO
5022009-07-01JILL OBANDO
5022008-07-01JILL OBANDO

Plan Statistics for GLOBAL WIRELESS SOLUTIONS, INC.

401k plan membership statisitcs for GLOBAL WIRELESS SOLUTIONS, INC.

Measure Date Value
2021: GLOBAL WIRELESS SOLUTIONS, INC. 2021 401k membership
Total participants, beginning-of-year2021-07-01157
Total number of active participants reported on line 7a of the Form 55002021-07-01141
Number of retired or separated participants receiving benefits2021-07-010
Total of all active and inactive participants2021-07-01141
2020: GLOBAL WIRELESS SOLUTIONS, INC. 2020 401k membership
Total participants, beginning-of-year2020-07-01143
Total number of active participants reported on line 7a of the Form 55002020-07-01157
Number of retired or separated participants receiving benefits2020-07-010
Total of all active and inactive participants2020-07-01157
2019: GLOBAL WIRELESS SOLUTIONS, INC. 2019 401k membership
Total participants, beginning-of-year2019-07-01144
Total number of active participants reported on line 7a of the Form 55002019-07-01143
Number of retired or separated participants receiving benefits2019-07-010
Total of all active and inactive participants2019-07-01143
2018: GLOBAL WIRELESS SOLUTIONS, INC. 2018 401k membership
Total participants, beginning-of-year2018-07-01140
Total number of active participants reported on line 7a of the Form 55002018-07-01144
Number of retired or separated participants receiving benefits2018-07-010
Total of all active and inactive participants2018-07-01144
2017: GLOBAL WIRELESS SOLUTIONS, INC. 2017 401k membership
Total participants, beginning-of-year2017-07-01156
Total number of active participants reported on line 7a of the Form 55002017-07-01140
Number of retired or separated participants receiving benefits2017-07-010
Total of all active and inactive participants2017-07-01140
2016: GLOBAL WIRELESS SOLUTIONS, INC. 2016 401k membership
Total participants, beginning-of-year2016-07-01139
Total number of active participants reported on line 7a of the Form 55002016-07-01156
Number of retired or separated participants receiving benefits2016-07-010
Total of all active and inactive participants2016-07-01156
2015: GLOBAL WIRELESS SOLUTIONS, INC. 2015 401k membership
Total participants, beginning-of-year2015-07-01171
Total number of active participants reported on line 7a of the Form 55002015-07-01139
Total of all active and inactive participants2015-07-01139
2014: GLOBAL WIRELESS SOLUTIONS, INC. 2014 401k membership
Total participants, beginning-of-year2014-07-01181
Total number of active participants reported on line 7a of the Form 55002014-07-01171
Total of all active and inactive participants2014-07-01171
2013: GLOBAL WIRELESS SOLUTIONS, INC. 2013 401k membership
Total participants, beginning-of-year2013-07-01168
Total number of active participants reported on line 7a of the Form 55002013-07-01181
Number of retired or separated participants receiving benefits2013-07-010
Total of all active and inactive participants2013-07-01181
2012: GLOBAL WIRELESS SOLUTIONS, INC. 2012 401k membership
Total participants, beginning-of-year2012-07-01146
Total number of active participants reported on line 7a of the Form 55002012-07-01165
Number of retired or separated participants receiving benefits2012-07-013
Total of all active and inactive participants2012-07-01168
2011: GLOBAL WIRELESS SOLUTIONS, INC. 2011 401k membership
Total participants, beginning-of-year2011-07-01147
Total number of active participants reported on line 7a of the Form 55002011-07-01145
Number of retired or separated participants receiving benefits2011-07-011
Total of all active and inactive participants2011-07-01146
2010: GLOBAL WIRELESS SOLUTIONS, INC. 2010 401k membership
Total participants, beginning-of-year2010-07-01147
Total number of active participants reported on line 7a of the Form 55002010-07-01145
Number of retired or separated participants receiving benefits2010-07-012
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01147
2009: GLOBAL WIRELESS SOLUTIONS, INC. 2009 401k membership
Total participants, beginning-of-year2009-07-01136
Total number of active participants reported on line 7a of the Form 55002009-07-01145
Number of retired or separated participants receiving benefits2009-07-012
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01147
2008: GLOBAL WIRELESS SOLUTIONS, INC. 2008 401k membership
Total participants, beginning-of-year2008-07-01123
Total number of active participants reported on line 7a of the Form 55002008-07-01134
Number of retired or separated participants receiving benefits2008-07-012
Number of other retired or separated participants entitled to future benefits2008-07-010
Total of all active and inactive participants2008-07-01136

Form 5500 Responses for GLOBAL WIRELESS SOLUTIONS, INC.

2021: GLOBAL WIRELESS SOLUTIONS, INC. 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: GLOBAL WIRELESS SOLUTIONS, INC. 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: GLOBAL WIRELESS SOLUTIONS, INC. 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: GLOBAL WIRELESS SOLUTIONS, INC. 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: GLOBAL WIRELESS SOLUTIONS, INC. 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: GLOBAL WIRELESS SOLUTIONS, INC. 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: GLOBAL WIRELESS SOLUTIONS, INC. 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: GLOBAL WIRELESS SOLUTIONS, INC. 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: GLOBAL WIRELESS SOLUTIONS, INC. 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: GLOBAL WIRELESS SOLUTIONS, INC. 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: GLOBAL WIRELESS SOLUTIONS, INC. 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: GLOBAL WIRELESS SOLUTIONS, INC. 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: GLOBAL WIRELESS SOLUTIONS, INC. 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01This submission is the final filingNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes
2008: GLOBAL WIRELESS SOLUTIONS, INC. 2008 form 5500 responses
2008-07-01Type of plan entitySingle employer plan
2008-07-01First time form 5500 has been submittedYes
2008-07-01This submission is the final filingNo
2008-07-01Plan funding arrangement – InsuranceYes
2008-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LEGAL SERVICES (National Association of Insurance Commissioners NAIC id number: 48402 )
Policy contract number4599
Policy instance 8
Insurance contract or identification number4599
Number of Individuals Covered17
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $447
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL INSURANCE,IDENTITY PROTECTION
Welfare Benefit Premiums Paid to CarrierUSD $7,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $447
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00611406
Policy instance 2
Insurance contract or identification number00611406
Number of Individuals Covered207
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $52,967
Total amount of fees paid to insurance companyUSD $33,213
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $663,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,967
Amount paid for insurance broker fees2210
Additional information about fees paid to insurance brokerINCETIVE COMPENSATION PAYMENTS BASED ON MEMBERSHIP IN THE PLAN OR LUM
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30026765
Policy instance 1
Insurance contract or identification number30026765
Number of Individuals Covered120
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $1,076
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,137
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,076
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL301784
Policy instance 3
Insurance contract or identification numberVPL301784
Number of Individuals Covered123
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $3,736
Total amount of fees paid to insurance companyUSD $606
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LONG TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $24,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,636
Amount paid for insurance broker fees606
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL152646
Policy instance 4
Insurance contract or identification numberGL152646
Number of Individuals Covered163
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $1,308
Total amount of fees paid to insurance companyUSD $237
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,273
Amount paid for insurance broker fees237
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number028426
Policy instance 5
Insurance contract or identification number028426
Number of Individuals Covered3
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVG188547
Policy instance 6
Insurance contract or identification numberVG188547
Number of Individuals Covered24
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $630
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY GROUP TERM LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $603
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG168579
Policy instance 7
Insurance contract or identification numberG168579
Number of Individuals Covered163
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $3,198
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,044
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL301784
Policy instance 3
Insurance contract or identification numberVPL301784
Number of Individuals Covered110
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $3,399
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30026765
Policy instance 1
Insurance contract or identification number30026765
Number of Individuals Covered133
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $542
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number028426
Policy instance 5
Insurance contract or identification number028426
Number of Individuals Covered3
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVG188547
Policy instance 6
Insurance contract or identification numberVG188547
Number of Individuals Covered25
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $149
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY GROUP TERM LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG168579
Policy instance 7
Insurance contract or identification numberG168579
Number of Individuals Covered169
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $1,081
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00611406
Policy instance 2
Insurance contract or identification number00611406
Number of Individuals Covered231
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $47,229
Total amount of fees paid to insurance companyUSD $27,822
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $626,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LEGAL SERVICES (National Association of Insurance Commissioners NAIC id number: 48402 )
Policy contract number4599
Policy instance 8
Insurance contract or identification number4599
Number of Individuals Covered19
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $78
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL INSURNCE, IDENTITY PROTECTION
Welfare Benefit Premiums Paid to CarrierUSD $1,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL152646
Policy instance 4
Insurance contract or identification numberGL152646
Number of Individuals Covered143
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $1,265
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number28426
Policy instance 5
Insurance contract or identification number28426
Number of Individuals Covered3
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL152646
Policy instance 4
Insurance contract or identification numberGL152646
Number of Individuals Covered151
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $1,139
Total amount of fees paid to insurance companyUSD $166
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,139
Amount paid for insurance broker fees166
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL301784
Policy instance 3
Insurance contract or identification numberVPL301784
Number of Individuals Covered113
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $2,775
Total amount of fees paid to insurance companyUSD $383
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,775
Amount paid for insurance broker fees383
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00611406
Policy instance 2
Insurance contract or identification number00611406
Number of Individuals Covered207
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $42,501
Total amount of fees paid to insurance companyUSD $28,256
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $431,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,501
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Amount paid for insurance broker fees24905
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30026765
Policy instance 1
Insurance contract or identification number30026765
Number of Individuals Covered121
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $1,050
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,439
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,050
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0611406
Policy instance 6
Insurance contract or identification number0611406
Number of Individuals Covered140
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $705
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $113,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees705
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION PAYMENTS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0611406
Policy instance 6
Insurance contract or identification number0611406
Number of Individuals Covered143
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $114,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number28426
Policy instance 5
Insurance contract or identification number28426
Number of Individuals Covered1
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL152646
Policy instance 4
Insurance contract or identification numberGL152646
Number of Individuals Covered149
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $910
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $910
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL301784
Policy instance 3
Insurance contract or identification numberVPL301784
Number of Individuals Covered109
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $1,841
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,841
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00611406
Policy instance 2
Insurance contract or identification number00611406
Number of Individuals Covered205
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $46,121
Total amount of fees paid to insurance companyUSD $25,623
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $401,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,121
Additional information about fees paid to insurance brokerSERVICE/AGENT FEES
Insurance broker organization code?3
Amount paid for insurance broker fees25623
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30026765
Policy instance 1
Insurance contract or identification number30026765
Number of Individuals Covered120
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $1,036
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,036
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00611406
Policy instance 2
Insurance contract or identification number00611406
Number of Individuals Covered204
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $47,624
Total amount of fees paid to insurance companyUSD $27,826
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $391,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL301784
Policy instance 3
Insurance contract or identification numberVPL301784
Number of Individuals Covered107
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,828
Total amount of fees paid to insurance companyUSD $335
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL152646
Policy instance 4
Insurance contract or identification numberGL152646
Number of Individuals Covered159
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,078
Total amount of fees paid to insurance companyUSD $216
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-007152
Policy instance 5
Insurance contract or identification number136-007152
Number of Individuals Covered137
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $14,611,461
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $135,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number28426
Policy instance 6
Insurance contract or identification number28426
Number of Individuals Covered1
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30026765
Policy instance 1
Insurance contract or identification number30026765
Number of Individuals Covered114
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,048
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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