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FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 401k Plan overview

Plan NameFORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN
Plan identification number 501

FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

FORMETCO, INC. has sponsored the creation of one or more 401k plans.

Company Name:FORMETCO, INC.
Employer identification number (EIN):581036723
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01MATT XANDER
5012017-01-01MATT XANDER
5012016-01-01MATT XANDER
5012015-01-01MATT XANDER
5012014-01-01MATT XANDER
5012013-01-01MATT XANDER
5012012-01-01MATT XANDER
5012011-01-01MATT XANDER
5012009-01-01MATT XANDER
5012009-01-01MATT XANDER

Plan Statistics for FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN

401k plan membership statisitcs for FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2022: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0171
Total number of active participants reported on line 7a of the Form 55002022-01-0193
Total of all active and inactive participants2022-01-0193
2021: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0171
Total number of active participants reported on line 7a of the Form 55002021-01-0172
Total of all active and inactive participants2021-01-0172
2020: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0178
Total number of active participants reported on line 7a of the Form 55002020-01-0175
Total of all active and inactive participants2020-01-0175
2019: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0195
Total number of active participants reported on line 7a of the Form 55002019-01-0186
Total of all active and inactive participants2019-01-0186
2018: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0189
Total number of active participants reported on line 7a of the Form 55002018-01-0189
Total of all active and inactive participants2018-01-0189
2017: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0174
Total number of active participants reported on line 7a of the Form 55002017-01-0189
Total of all active and inactive participants2017-01-0189
2016: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0169
Total number of active participants reported on line 7a of the Form 55002016-01-0190
Total of all active and inactive participants2016-01-0190
2015: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0170
Total number of active participants reported on line 7a of the Form 55002015-01-0166
Number of retired or separated participants receiving benefits2015-01-011
Total of all active and inactive participants2015-01-0167
2014: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0166
Total number of active participants reported on line 7a of the Form 55002014-01-0174
Total of all active and inactive participants2014-01-0174
2013: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0173
Total number of active participants reported on line 7a of the Form 55002013-01-0171
Total of all active and inactive participants2013-01-0171
2012: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0160
Total number of active participants reported on line 7a of the Form 55002012-01-0172
Number of retired or separated participants receiving benefits2012-01-011
Total of all active and inactive participants2012-01-0173
2011: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0159
Total number of active participants reported on line 7a of the Form 55002011-01-0159
Total of all active and inactive participants2011-01-0159
2009: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0195
Total number of active participants reported on line 7a of the Form 55002009-01-0165
Number of retired or separated participants receiving benefits2009-01-013
Total of all active and inactive participants2009-01-0168

Financial Data on FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2022 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2022 401k financial data
Total income from all sources2022-12-31$1,227,974
Expenses. Total of all expenses incurred2022-12-31$1,223,124
Benefits paid (including direct rollovers)2022-12-31$1,086,716
Total plan assets at end of year2022-12-31$9,850
Total plan assets at beginning of year2022-12-31$5,000
Value of fidelity bond covering the plan2022-12-31$1,000,000
Total contributions received or receivable from participants2022-12-31$257,913
Net income (gross income less expenses)2022-12-31$4,850
Net plan assets at end of year (total assets less liabilities)2022-12-31$9,850
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$5,000
Total contributions received or receivable from employer(s)2022-12-31$970,061
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$136,408
2021 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 401k financial data
Total income from all sources2021-12-31$1,121,749
Expenses. Total of all expenses incurred2021-12-31$1,121,749
Benefits paid (including direct rollovers)2021-12-31$1,024,337
Total plan assets at end of year2021-12-31$5,000
Total plan assets at beginning of year2021-12-31$5,000
Value of fidelity bond covering the plan2021-12-31$1,000,000
Total contributions received or receivable from participants2021-12-31$210,481
Net income (gross income less expenses)2021-12-31$0
Net plan assets at end of year (total assets less liabilities)2021-12-31$5,000
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$5,000
Total contributions received or receivable from employer(s)2021-12-31$911,268
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$97,412
2020 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 401k financial data
Total income from all sources2020-12-31$897,278
Expenses. Total of all expenses incurred2020-12-31$1,006,501
Benefits paid (including direct rollovers)2020-12-31$904,639
Total plan assets at end of year2020-12-31$5,000
Total plan assets at beginning of year2020-12-31$114,223
Value of fidelity bond covering the plan2020-12-31$1,000,000
Total contributions received or receivable from participants2020-12-31$208,050
Net income (gross income less expenses)2020-12-31$-109,223
Net plan assets at end of year (total assets less liabilities)2020-12-31$5,000
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$114,223
Total contributions received or receivable from employer(s)2020-12-31$689,228
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$101,862
2019 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 401k financial data
Total income from all sources2019-12-31$1,364,214
Expenses. Total of all expenses incurred2019-12-31$1,259,950
Benefits paid (including direct rollovers)2019-12-31$1,198,181
Total plan assets at end of year2019-12-31$114,223
Total plan assets at beginning of year2019-12-31$9,959
Value of fidelity bond covering the plan2019-12-31$1,700,000
Total contributions received or receivable from participants2019-12-31$114,069
Net income (gross income less expenses)2019-12-31$104,264
Net plan assets at end of year (total assets less liabilities)2019-12-31$114,223
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$9,959
Total contributions received or receivable from employer(s)2019-12-31$1,250,145
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$61,769
2018 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k financial data
Total income from all sources2018-12-31$931,764
Expenses. Total of all expenses incurred2018-12-31$930,762
Benefits paid (including direct rollovers)2018-12-31$825,306
Total plan assets at end of year2018-12-31$9,959
Total plan assets at beginning of year2018-12-31$8,957
Value of fidelity bond covering the plan2018-12-31$1,700,000
Total contributions received or receivable from participants2018-12-31$169,847
Net income (gross income less expenses)2018-12-31$1,002
Net plan assets at end of year (total assets less liabilities)2018-12-31$9,959
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$8,957
Total contributions received or receivable from employer(s)2018-12-31$761,917
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$105,456
2017 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k financial data
Total income from all sources2017-12-31$855,120
Expenses. Total of all expenses incurred2017-12-31$854,559
Benefits paid (including direct rollovers)2017-12-31$739,635
Total plan assets at end of year2017-12-31$8,957
Total plan assets at beginning of year2017-12-31$8,396
Value of fidelity bond covering the plan2017-12-31$1,700,000
Total contributions received or receivable from participants2017-12-31$186,535
Net income (gross income less expenses)2017-12-31$561
Net plan assets at end of year (total assets less liabilities)2017-12-31$8,957
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$8,396
Total contributions received or receivable from employer(s)2017-12-31$668,585
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$114,924
2016 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k financial data
Total income from all sources2016-12-31$637,519
Expenses. Total of all expenses incurred2016-12-31$673,991
Benefits paid (including direct rollovers)2016-12-31$621,166
Total plan assets at end of year2016-12-31$8,396
Total plan assets at beginning of year2016-12-31$44,868
Value of fidelity bond covering the plan2016-12-31$1,700,000
Total contributions received or receivable from participants2016-12-31$163,373
Net income (gross income less expenses)2016-12-31$-36,472
Net plan assets at end of year (total assets less liabilities)2016-12-31$8,396
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$44,868
Total contributions received or receivable from employer(s)2016-12-31$474,146
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$52,825
2015 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k financial data
Total income from all sources2015-12-31$719,680
Expenses. Total of all expenses incurred2015-12-31$716,497
Benefits paid (including direct rollovers)2015-12-31$562,817
Total plan assets at end of year2015-12-31$44,868
Total plan assets at beginning of year2015-12-31$41,685
Value of fidelity bond covering the plan2015-12-31$1,700,000
Total contributions received or receivable from participants2015-12-31$161,723
Net income (gross income less expenses)2015-12-31$3,183
Net plan assets at end of year (total assets less liabilities)2015-12-31$44,868
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$41,685
Total contributions received or receivable from employer(s)2015-12-31$557,957
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$153,680
2014 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k financial data
Total income from all sources2014-12-31$776,240
Expenses. Total of all expenses incurred2014-12-31$775,214
Benefits paid (including direct rollovers)2014-12-31$616,961
Total plan assets at end of year2014-12-31$41,685
Total plan assets at beginning of year2014-12-31$40,659
Value of fidelity bond covering the plan2014-12-31$1,200,000
Total contributions received or receivable from participants2014-12-31$181,956
Net income (gross income less expenses)2014-12-31$1,026
Net plan assets at end of year (total assets less liabilities)2014-12-31$41,685
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$40,659
Total contributions received or receivable from employer(s)2014-12-31$594,284
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$158,253
2013 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k financial data
Total income from all sources2013-12-31$610,513
Expenses. Total of all expenses incurred2013-12-31$581,210
Benefits paid (including direct rollovers)2013-12-31$438,890
Total plan assets at end of year2013-12-31$40,659
Total plan assets at beginning of year2013-12-31$11,356
Value of fidelity bond covering the plan2013-12-31$1,200,000
Total contributions received or receivable from participants2013-12-31$168,907
Net income (gross income less expenses)2013-12-31$29,303
Net plan assets at end of year (total assets less liabilities)2013-12-31$40,659
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$11,356
Total contributions received or receivable from employer(s)2013-12-31$441,606
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$142,320
2012 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k financial data
Total income from all sources2012-12-31$545,011
Expenses. Total of all expenses incurred2012-12-31$535,411
Benefits paid (including direct rollovers)2012-12-31$389,497
Total plan assets at end of year2012-12-31$11,356
Total plan assets at beginning of year2012-12-31$1,756
Value of fidelity bond covering the plan2012-12-31$1,200,000
Total contributions received or receivable from participants2012-12-31$157,859
Net income (gross income less expenses)2012-12-31$9,600
Net plan assets at end of year (total assets less liabilities)2012-12-31$11,356
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,756
Total contributions received or receivable from employer(s)2012-12-31$387,152
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$145,914
2011 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k financial data
Total income from all sources2011-12-31$444,734
Expenses. Total of all expenses incurred2011-12-31$443,978
Benefits paid (including direct rollovers)2011-12-31$329,576
Total plan assets at end of year2011-12-31$1,756
Total plan assets at beginning of year2011-12-31$1,000
Value of fidelity bond covering the plan2011-12-31$1,200,000
Total contributions received or receivable from participants2011-12-31$129,340
Net income (gross income less expenses)2011-12-31$756
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,756
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,000
Total contributions received or receivable from employer(s)2011-12-31$315,394
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$114,402
2010 : FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2010 401k financial data
Total income from all sources2010-12-31$468,772
Expenses. Total of all expenses incurred2010-12-31$469,914
Benefits paid (including direct rollovers)2010-12-31$353,995
Total plan assets at end of year2010-12-31$1,000
Total plan assets at beginning of year2010-12-31$2,142
Value of fidelity bond covering the plan2010-12-31$1,200,000
Total contributions received or receivable from participants2010-12-31$159,411
Net income (gross income less expenses)2010-12-31$-1,142
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,000
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$2,142
Total contributions received or receivable from employer(s)2010-12-31$309,361
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$115,919

Form 5500 Responses for FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN

2022: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: FORMETCO, INC. EMPLOYEE HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number937158
Policy instance 1
Insurance contract or identification number937158
Number of Individuals Covered93
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $59,914
Total amount of fees paid to insurance companyUSD $0
Health 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 $39,943
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number937158
Policy instance 1
Insurance contract or identification number937158
Number of Individuals Covered72
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $34,502
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,502
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number937158
Policy instance 1
Insurance contract or identification number937158
Number of Individuals Covered75
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $35,113
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,113
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417003412424
Policy instance 1
Insurance contract or identification number417003412424
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417003412424
Policy instance 1
Insurance contract or identification number417003412424
Number of Individuals Covered89
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,423
Total amount of fees paid to insurance companyUSD $0
Health 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 $9,461
Additional information about fees paid to insurance brokerMANAGING PRODUCER FEE
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417003412424
Policy instance 1
Insurance contract or identification number417003412424
Number of Individuals Covered88
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $17,757
Total amount of fees paid to insurance companyUSD $0
Health 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 $17,757
Additional information about fees paid to insurance brokerMANAGING PRODUCER FEE
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES INC.

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