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JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameJONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN
Plan identification number 501

JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

JONES PLASTIC & ENGINEERING COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name:JONES PLASTIC & ENGINEERING COMPANY, LLC
Employer identification number (EIN):610592989
NAIC Classification:326100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01CHRISTY WILLIAMS2023-07-21
5012021-01-01CHRISTY WILLIAMS2022-07-22
5012020-01-01CHRISTY WILLIAMS2021-07-23
5012019-01-01CHRISTY WILLIAMS2020-07-29
5012018-01-01
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012014-01-01
5012013-01-01
5012012-01-01CHRISTY WILLIAMS
5012011-01-01CHRISTY WILLIAMS
5012010-01-01CHRISTY WILLIAMS
5012009-01-01CHRISTY WILLIAMS CRAIG JONES2010-10-14

Plan Statistics for JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN

Measure Date Value
2022: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01609
Total number of active participants reported on line 7a of the Form 55002022-01-01646
Total of all active and inactive participants2022-01-01646
2021: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01623
Total number of active participants reported on line 7a of the Form 55002021-01-01609
Total of all active and inactive participants2021-01-01609
2020: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01650
Total number of active participants reported on line 7a of the Form 55002020-01-01631
Total of all active and inactive participants2020-01-01631
2019: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01657
Total number of active participants reported on line 7a of the Form 55002019-01-01650
Total of all active and inactive participants2019-01-01650
2018: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01660
Total number of active participants reported on line 7a of the Form 55002018-01-01657
Total of all active and inactive participants2018-01-01657
2017: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01573
Total number of active participants reported on line 7a of the Form 55002017-01-01660
Total of all active and inactive participants2017-01-01660
Total participants2017-01-01660
2016: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01562
Total number of active participants reported on line 7a of the Form 55002016-01-01567
Number of retired or separated participants receiving benefits2016-01-016
Total of all active and inactive participants2016-01-01573
Total participants2016-01-01573
2015: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01547
Total number of active participants reported on line 7a of the Form 55002015-01-01562
Total of all active and inactive participants2015-01-01562
Total participants2015-01-01562
2014: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01518
Total number of active participants reported on line 7a of the Form 55002014-01-010
Total of all active and inactive participants2014-01-010
Total participants2014-01-010
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
2013: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01465
Total number of active participants reported on line 7a of the Form 55002013-01-01518
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01518
2012: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01465
Total number of active participants reported on line 7a of the Form 55002012-01-01465
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01465
2011: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01633
Total number of active participants reported on line 7a of the Form 55002011-01-01475
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01475
2010: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01633
Total number of active participants reported on line 7a of the Form 55002010-01-01620
Number of retired or separated participants receiving benefits2010-01-0113
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01633
2009: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01560
Total number of active participants reported on line 7a of the Form 55002009-01-01898
Number of retired or separated participants receiving benefits2009-01-017
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01905

Form 5500 Responses for JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN

2022: JONES PLASTIC & ENGINEERING LLC WELFARE 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 – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: JONES PLASTIC & ENGINEERING LLC WELFARE 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 – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: JONES PLASTIC & ENGINEERING LLC WELFARE 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 – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: JONES PLASTIC & ENGINEERING LLC WELFARE 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 – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: JONES PLASTIC & ENGINEERING LLC WELFARE 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 – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: JONES PLASTIC & ENGINEERING LLC WELFARE 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 – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: JONES PLASTIC & ENGINEERING LLC WELFARE 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 – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01This submission is the final filingYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: JONES PLASTIC & ENGINEERING LLC WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number46418
Policy instance 5
Insurance contract or identification number46418
Number of Individuals Covered519
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,615
Other welfare benefits providedTELEMEDICINE
Welfare Benefit Premiums Paid to CarrierUSD $17,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,615
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886416G
Policy instance 4
Insurance contract or identification number886416G
Number of Individuals Covered646
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $59,783
Total amount of fees paid to insurance companyUSD $1,983
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $398,555
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59,783
Insurance broker organization code?3
Amount paid for insurance broker fees1983
Additional information about fees paid to insurance brokerBONUS
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number13431
Policy instance 3
Insurance contract or identification number13431
Number of Individuals Covered461
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,345
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,345
Insurance broker organization code?3
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract numberDU5055
Policy instance 2
Insurance contract or identification numberDU5055
Number of Individuals Covered832
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,469
Dental 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 $3,469
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417002414306
Policy instance 1
Insurance contract or identification number417002414306
Number of Individuals Covered521
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $19,083
Welfare Benefit Premiums Paid to CarrierUSD $290,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,083
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417002414306
Policy instance 1
Insurance contract or identification number417002414306
Number of Individuals Covered526
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $17,720
Welfare Benefit Premiums Paid to CarrierUSD $270,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,720
Insurance broker organization code?3
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract numberDU5055
Policy instance 2
Insurance contract or identification numberDU5055
Number of Individuals Covered823
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,373
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,311
Insurance broker organization code?3
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number13431
Policy instance 3
Insurance contract or identification number13431
Number of Individuals Covered434
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,708
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,708
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886416G
Policy instance 4
Insurance contract or identification number886416G
Number of Individuals Covered609
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $59,476
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $396,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59,476
Insurance broker organization code?3
TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number
Policy instance 5
Number of Individuals Covered493
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,487
Other welfare benefits providedTELEMEDICINE
Welfare Benefit Premiums Paid to CarrierUSD $18,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,487
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417002414306
Policy instance 1
Insurance contract or identification number417002414306
Number of Individuals Covered520
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,622
Welfare Benefit Premiums Paid to CarrierUSD $284,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,622
Insurance broker organization code?3
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract numberDU5055
Policy instance 2
Insurance contract or identification numberDU5055
Number of Individuals Covered810
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,191
Dental 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 $3,191
Insurance broker organization code?3
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number13431
Policy instance 3
Insurance contract or identification number13431
Number of Individuals Covered432
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,623
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,623
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886416G
Policy instance 4
Insurance contract or identification number886416G
Number of Individuals Covered631
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $49,098
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $327,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,098
Insurance broker organization code?3
TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number46418
Policy instance 5
Insurance contract or identification number46418
Number of Individuals Covered575
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,954
Other welfare benefits providedTELEMEDICINE
Welfare Benefit Premiums Paid to CarrierUSD $18,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,954
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number886416G
Policy instance 4
Insurance contract or identification number886416G
Number of Individuals Covered650
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $52,257
Total amount of fees paid to insurance companyUSD $14,857
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $357,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,257
Amount paid for insurance broker fees14857
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number13431
Policy instance 3
Insurance contract or identification number13431
Number of Individuals Covered481
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,879
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,879
Insurance broker organization code?3
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract numberDU5055
Policy instance 2
Insurance contract or identification numberDU5055
Number of Individuals Covered937
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,578
Dental 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 $3,578
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL34062
Policy instance 1
Insurance contract or identification numberHCL34062
Number of Individuals Covered567
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Welfare Benefit Premiums Paid to CarrierUSD $300,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 20641
Policy instance 6
Insurance contract or identification number400001000 20641
Number of Individuals Covered415
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $23,414
Total amount of fees paid to insurance companyUSD $1,918
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $156,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,414
Amount paid for insurance broker fees1918
Additional information about fees paid to insurance brokerFEES & BROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10211875
Policy instance 5
Insurance contract or identification number10211875
Number of Individuals Covered560
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $11,211
Total amount of fees paid to insurance companyUSD $937
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOPTIONAL LTD
Welfare Benefit Premiums Paid to CarrierUSD $74,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,211
Amount paid for insurance broker fees937
Additional information about fees paid to insurance brokerFEES & BROKER BONUS
Insurance broker organization code?3
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number13431
Policy instance 3
Insurance contract or identification number13431
Number of Individuals Covered463
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,654
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,654
Insurance broker organization code?3
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract numberDU5055
Policy instance 2
Insurance contract or identification numberDU5055
Number of Individuals Covered962
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,432
Dental 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 $3,432
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL34062
Policy instance 1
Insurance contract or identification numberHCL34062
Number of Individuals Covered561
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Welfare Benefit Premiums Paid to CarrierUSD $280,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10211874
Policy instance 4
Insurance contract or identification number10211874
Number of Individuals Covered657
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $15,173
Total amount of fees paid to insurance companyUSD $1,262
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $101,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,173
Amount paid for insurance broker fees1262
Additional information about fees paid to insurance brokerFEES & BROKER BONUS
Insurance broker organization code?3
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number632410
Policy instance 1
Insurance contract or identification number632410
Number of Individuals Covered553
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $37,553
Total amount of fees paid to insurance companyUSD $5,092
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $448,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,553
Amount paid for insurance broker fees5092
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS, LLC
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract numberDU5055
Policy instance 2
Insurance contract or identification numberDU5055
Number of Individuals Covered968
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,411
Dental 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 $3,411
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS, LLC
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number13431
Policy instance 3
Insurance contract or identification number13431
Number of Individuals Covered124
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,547
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,547
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10211874
Policy instance 4
Insurance contract or identification number10211874
Number of Individuals Covered660
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $15,003
Total amount of fees paid to insurance companyUSD $2,967
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $100,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,217
Amount paid for insurance broker fees2715
Additional information about fees paid to insurance brokerFEES AND BROKER BONUS
Insurance broker organization code?3
Insurance broker nameEPIC INS SOLUTIONS AGENCY, LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10211875
Policy instance 5
Insurance contract or identification number10211875
Number of Individuals Covered797
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $11,400
Total amount of fees paid to insurance companyUSD $1,903
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LTD
Welfare Benefit Premiums Paid to CarrierUSD $76,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,595
Amount paid for insurance broker fees1716
Additional information about fees paid to insurance brokerFEES AND BROKER BONUS
Insurance broker organization code?3
Insurance broker nameEPIC INS SOLUTIONS AGENCY, LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 20641
Policy instance 6
Insurance contract or identification number400001000 20641
Number of Individuals Covered637
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $21,430
Total amount of fees paid to insurance companyUSD $4,202
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $142,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,995
Amount paid for insurance broker fees3840
Additional information about fees paid to insurance brokerFEES AND BROKER BONUS
Insurance broker organization code?3
Insurance broker nameEPIC INS SOLUTIONS AGENCY, LLC
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number632410
Policy instance 1
Insurance contract or identification number632410
Number of Individuals Covered562
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $34,918
Total amount of fees paid to insurance companyUSD $11,612
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $458,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,918
Amount paid for insurance broker fees11612
Additional information about fees paid to insurance brokerBONUS & NON-MONETARY
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS, LLC
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract numberDU5055
Policy instance 2
Insurance contract or identification numberDU5055
Number of Individuals Covered970
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,232
Dental 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 $3,232
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS, LLC
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number13431
Policy instance 3
Insurance contract or identification number13431
Number of Individuals Covered427
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,772
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,772
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS, LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number011782
Policy instance 5
Insurance contract or identification number011782
Number of Individuals Covered719
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $33,051
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $201,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,051
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS, LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number011782
Policy instance 6
Insurance contract or identification number011782
Number of Individuals Covered729
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $9,289
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,289
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS, LLC
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number632410
Policy instance 1
Insurance contract or identification number632410
Number of Individuals Covered547
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $28,551
Total amount of fees paid to insurance companyUSD $4,147
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 $28,551
Amount paid for insurance broker fees4147
Additional information about fees paid to insurance brokerVOLUME INCENTIVES/NON-MONETARY PAID
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS, LLC
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number00108621
Policy instance 2
Insurance contract or identification number00108621
Number of Individuals Covered0
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $-168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number632410
Policy instance 1
Insurance contract or identification number632410
Number of Individuals Covered518
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $22,861
Total amount of fees paid to insurance companyUSD $1,222
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,988
Amount paid for insurance broker fees20
Additional information about fees paid to insurance brokerNON-MONETARY PAID
Insurance broker organization code?3
Insurance broker nameASSURED NL INSURANCE AGENCY, INC.

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