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WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 401k Plan overview

Plan NameWILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN
Plan identification number 501

WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN Benefits

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

401k Sponsoring company profile

WILLIAMS STEEL COMPANY, INC has sponsored the creation of one or more 401k plans.

Company Name:WILLIAMS STEEL COMPANY, INC
Employer identification number (EIN):620692346
NAIC Classification:331200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT 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
5012018-01-01JOHN CAMPBELL
5012017-01-01JOHN CAMPBELL
5012016-01-01JOHN CAMPBELL
5012015-01-01JOHN CAMPBELL
5012014-01-01JOHN CAMPBELL
5012013-01-01JOHN CAMPBELL
5012012-01-01CHARLES CAMPBELL
5012011-01-01JOHN CAMPBELL
5012010-01-01JOHN CAMPBELL
5012009-01-01JOHN CAMPBELL

Plan Statistics for WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN

401k plan membership statisitcs for WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2022: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01225
Total number of active participants reported on line 7a of the Form 55002022-01-01269
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01269
2021: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01225
Total number of active participants reported on line 7a of the Form 55002021-01-01225
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01225
2020: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01164
Total number of active participants reported on line 7a of the Form 55002020-01-01215
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01215
2019: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01164
Total number of active participants reported on line 7a of the Form 55002019-01-01164
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01164
2018: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01160
Total number of active participants reported on line 7a of the Form 55002018-01-01163
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01163
2017: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01167
Total number of active participants reported on line 7a of the Form 55002017-01-01160
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01160
2016: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01151
Total number of active participants reported on line 7a of the Form 55002016-01-01167
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01167
2015: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01119
Total number of active participants reported on line 7a of the Form 55002015-01-01151
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01151
2014: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01107
Total number of active participants reported on line 7a of the Form 55002014-01-01119
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01119
2013: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0190
Total number of active participants reported on line 7a of the Form 55002013-01-01107
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 participants2013-01-01107
2012: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0188
Total number of active participants reported on line 7a of the Form 55002012-01-0190
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 participants2012-01-0190
Total participants2012-01-0190
2011: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0184
Total number of active participants reported on line 7a of the Form 55002011-01-0188
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 participants2011-01-0188
2010: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01109
Total number of active participants reported on line 7a of the Form 55002010-01-0180
Number of retired or separated participants receiving benefits2010-01-014
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-0184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01115
Total number of active participants reported on line 7a of the Form 55002009-01-01104
Number of retired or separated participants receiving benefits2009-01-015
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2020 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 401k financial data
Total income from all sources2020-12-31$885,333
Expenses. Total of all expenses incurred2020-12-31$885,333
Benefits paid (including direct rollovers)2020-12-31$800,362
Total plan assets at end of year2020-12-31$0
Total plan assets at beginning of year2020-12-31$0
Total contributions received or receivable from participants2020-12-31$191,145
Net plan assets at end of year (total assets less liabilities)2020-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$0
Total contributions received or receivable from employer(s)2020-12-31$694,188
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$84,971
2019 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k financial data
Total income from all sources2019-12-31$1,541,673
Expenses. Total of all expenses incurred2019-12-31$1,541,673
Benefits paid (including direct rollovers)2019-12-31$1,476,946
Total plan assets at end of year2019-12-31$0
Total plan assets at beginning of year2019-12-31$0
Total contributions received or receivable from participants2019-12-31$165,949
Net plan assets at end of year (total assets less liabilities)2019-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$0
Total contributions received or receivable from employer(s)2019-12-31$1,375,724
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$64,727
2018 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 401k financial data
Total income from all sources2018-12-31$1,202,847
Expenses. Total of all expenses incurred2018-12-31$1,202,847
Benefits paid (including direct rollovers)2018-12-31$1,139,443
Total plan assets at end of year2018-12-31$0
Total plan assets at beginning of year2018-12-31$0
Total contributions received or receivable from participants2018-12-31$162,872
Net plan assets at end of year (total assets less liabilities)2018-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$0
Total contributions received or receivable from employer(s)2018-12-31$1,039,975
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$63,404
2017 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2017 401k financial data
Total income from all sources2017-12-31$934,532
Expenses. Total of all expenses incurred2017-12-31$934,532
Benefits paid (including direct rollovers)2017-12-31$892,857
Total plan assets at end of year2017-12-31$0
Total plan assets at beginning of year2017-12-31$0
Total contributions received or receivable from participants2017-12-31$150,935
Net plan assets at end of year (total assets less liabilities)2017-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$0
Total contributions received or receivable from employer(s)2017-12-31$783,597
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$41,675
2016 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k financial data
Total income from all sources2016-12-31$1,208,807
Expenses. Total of all expenses incurred2016-12-31$1,208,807
Benefits paid (including direct rollovers)2016-12-31$1,167,076
Total plan assets at end of year2016-12-31$0
Total plan assets at beginning of year2016-12-31$0
Total contributions received or receivable from participants2016-12-31$154,165
Net plan assets at end of year (total assets less liabilities)2016-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$0
Total contributions received or receivable from employer(s)2016-12-31$1,054,642
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$41,731
2015 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k financial data
Total income from all sources2015-12-31$984,373
Expenses. Total of all expenses incurred2015-12-31$984,373
Benefits paid (including direct rollovers)2015-12-31$940,185
Total plan assets at end of year2015-12-31$0
Total plan assets at beginning of year2015-12-31$0
Total contributions received or receivable from participants2015-12-31$154,315
Net plan assets at end of year (total assets less liabilities)2015-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$0
Total contributions received or receivable from employer(s)2015-12-31$830,058
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$44,188
2014 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k financial data
Total income from all sources2014-12-31$1,207,031
Expenses. Total of all expenses incurred2014-12-31$1,207,031
Benefits paid (including direct rollovers)2014-12-31$1,164,969
Total plan assets at end of year2014-12-31$0
Total plan assets at beginning of year2014-12-31$0
Total contributions received or receivable from participants2014-12-31$174,225
Net plan assets at end of year (total assets less liabilities)2014-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$1,032,806
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$42,062
2013 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2013 401k financial data
Total income from all sources2013-12-31$1,203,849
Expenses. Total of all expenses incurred2013-12-31$1,203,849
Benefits paid (including direct rollovers)2013-12-31$1,169,185
Total plan assets at end of year2013-12-31$0
Total plan assets at beginning of year2013-12-31$0
Total contributions received or receivable from participants2013-12-31$141,265
Net plan assets at end of year (total assets less liabilities)2013-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$1,062,584
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$34,664
2012 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2012 401k financial data
Total income from all sources2012-12-31$791,467
Expenses. Total of all expenses incurred2012-12-31$791,467
Benefits paid (including direct rollovers)2012-12-31$751,497
Total plan assets at end of year2012-12-31$0
Total plan assets at beginning of year2012-12-31$0
Total contributions received or receivable from participants2012-12-31$129,560
Net plan assets at end of year (total assets less liabilities)2012-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$661,907
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$39,970
2011 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2011 401k financial data
Total income from all sources2011-12-31$774,845
Expenses. Total of all expenses incurred2011-12-31$774,845
Benefits paid (including direct rollovers)2011-12-31$737,629
Total plan assets at end of year2011-12-31$0
Total plan assets at beginning of year2011-12-31$0
Total contributions received or receivable from participants2011-12-31$116,695
Net plan assets at end of year (total assets less liabilities)2011-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$658,150
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$37,216
2010 : WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2010 401k financial data
Total transfer of assets to this plan2010-12-31$0
Total transfer of assets from this plan2010-12-31$0
Total income from all sources (including contributions)2010-12-31$751,483
Total of all expenses incurred2010-12-31$751,483
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$712,387
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$751,483
Value of total assets at end of year2010-12-31$0
Value of total assets at beginning of year2010-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$39,096
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$24,000
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$117,585
Total non interest bearing cash at end of year2010-12-31$0
Total non interest bearing cash at beginning of year2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$0
Value of net assets at end of year (total assets less liabilities)2010-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$122,778
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$633,898
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$589,609
Contract administrator fees2010-12-31$15,096
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31BADGETT, PAYNE & WARREN, PC
Accountancy firm EIN2010-12-31621202322

Form 5500 Responses for WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN

2022: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
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: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
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 – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: WILLIAMS STEEL CO SELF FUNDED MEDICAL REIMBURSEMENT 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 – 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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AARG
Policy instance 5
Insurance contract or identification numberGVTL0AARG
Number of Individuals Covered16
Insurance policy start date2021-09-01
Insurance policy end date2022-09-01
Total amount of commissions paid to insurance brokerUSD $1,465
Welfare Benefit Premiums Paid to CarrierUSD $9,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,465
Insurance broker organization code?3
CYPRESS BENEFIT ADMINISTRATORS (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract numberN18-0001
Policy instance 4
Insurance contract or identification numberN18-0001
Number of Individuals Covered151
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $121,101
Welfare Benefit Premiums Paid to CarrierUSD $121,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees53092
Insurance broker organization code?3
QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberOTP01140-22
Policy instance 3
Insurance contract or identification numberOTP01140-22
Number of Individuals Covered146
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Welfare Benefit Premiums Paid to CarrierUSD $19,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AARG
Policy instance 2
Insurance contract or identification numberGLTD0AARG
Number of Individuals Covered269
Insurance policy start date2021-09-01
Insurance policy end date2022-09-01
Total amount of commissions paid to insurance brokerUSD $3,908
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,908
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberIISI 3548-21
Policy instance 1
Insurance contract or identification numberIISI 3548-21
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberIISI 3548-21
Policy instance 1
Insurance contract or identification numberIISI 3548-21
Number of Individuals Covered140
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Welfare Benefit Premiums Paid to CarrierUSD $227,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUGOAARG
Policy instance 2
Insurance contract or identification numberGLUGOAARG
Number of Individuals Covered225
Insurance policy start date2020-09-01
Insurance policy end date2021-09-01
Total amount of commissions paid to insurance brokerUSD $6,715
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,715
Insurance broker organization code?3
QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberOTP01140-21
Policy instance 3
Insurance contract or identification numberOTP01140-21
Number of Individuals Covered131
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Welfare Benefit Premiums Paid to CarrierUSD $18,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CYPRESS BENEFIT ADMINISTRATORS (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract numberN18-0001
Policy instance 4
Insurance contract or identification numberN18-0001
Number of Individuals Covered139
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $22,673
Total amount of fees paid to insurance companyUSD $78,770
Welfare Benefit Premiums Paid to CarrierUSD $78,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees43878
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $22,673
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUGOAARG
Policy instance 2
Insurance contract or identification numberGLUGOAARG
Number of Individuals Covered215
Insurance policy start date2019-09-01
Insurance policy end date2020-09-01
Total amount of commissions paid to insurance brokerUSD $5,346
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,346
Insurance broker organization code?3
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract number20019122
Policy instance 1
Insurance contract or identification number20019122
Number of Individuals Covered118
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Welfare Benefit Premiums Paid to CarrierUSD $210,886
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUGOAARG
Policy instance 2
Insurance contract or identification numberGLUGOAARG
Number of Individuals Covered164
Insurance policy start date2018-09-01
Insurance policy end date2019-09-01
Total amount of commissions paid to insurance brokerUSD $4,949
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,949
Insurance broker organization code?3
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract number20019122
Policy instance 1
Insurance contract or identification number20019122
Number of Individuals Covered117
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Welfare Benefit Premiums Paid to CarrierUSD $171,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUGOAARG
Policy instance 2
Insurance contract or identification numberGLUGOAARG
Number of Individuals Covered163
Insurance policy start date2017-09-01
Insurance policy end date2018-09-01
Total amount of commissions paid to insurance brokerUSD $4,747
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,747
Insurance broker organization code?3
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract number20018865
Policy instance 1
Insurance contract or identification number20018865
Number of Individuals Covered121
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Welfare Benefit Premiums Paid to CarrierUSD $162,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUGOAARG
Policy instance 2
Insurance contract or identification numberGLUGOAARG
Number of Individuals Covered160
Insurance policy start date2016-09-01
Insurance policy end date2017-09-01
Total amount of commissions paid to insurance brokerUSD $4,350
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,350
Insurance broker organization code?3
Insurance broker nameSHERRI LARAE KILBURN
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract number20018634
Policy instance 1
Insurance contract or identification number20018634
Number of Individuals Covered107
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,842
Welfare Benefit Premiums Paid to CarrierUSD $156,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,842
Insurance broker organization code?3
Insurance broker nameHEALTH PARTNERS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGJLTD0AARG
Policy instance 2
Insurance contract or identification numberGJLTD0AARG
Number of Individuals Covered151
Insurance policy start date2014-09-01
Insurance policy end date2015-09-01
Total amount of commissions paid to insurance brokerUSD $4,495
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,845
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,495
Insurance broker organization code?3
Insurance broker nameSHERRI LARAC KIMBURN
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract number20018155
Policy instance 1
Insurance contract or identification number20018155
Number of Individuals Covered108
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $9,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,025
Insurance broker organization code?3
Insurance broker nameHEALTH PARTNERS
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract number20017674
Policy instance 1
Insurance contract or identification number20017674
Number of Individuals Covered119
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,806
Insurance broker organization code?3
Insurance broker nameHEALTH PARTNERS
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract number20017336
Policy instance 1
Insurance contract or identification number20017336
Number of Individuals Covered107
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $7,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,294
Insurance broker organization code?3
Insurance broker nameHEALTH PARTNERS
LLOYD'S OF LONDON (National Association of Insurance Commissioners NAIC id number: AA-11 )
Policy contract number20016841
Policy instance 1
Insurance contract or identification number20016841
Number of Individuals Covered90
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $6,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,868
Insurance broker organization code?3
Insurance broker nameHEALTH PARTNERS
LLOYD'S OF LONDON (National Association of Insurance Commissioners NAIC id number: AA-11 )
Policy contract number20016400
Policy instance 1
Insurance contract or identification number20016400
Number of Individuals Covered88
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LLOYD'S OF LONDON (National Association of Insurance Commissioners NAIC id number: AA-11 )
Policy contract number20015893
Policy instance 1
Insurance contract or identification number20015893
Number of Individuals Covered84
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $5,674
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,674
Insurance broker organization code?3
Insurance broker nameHEALTH PARTNERS

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