BUILDERS TRANSPORTATION COMPANY, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN
401k plan membership statisitcs for BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2018: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 218 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2018-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
| Total of all active and inactive participants | 2018-07-01 | 0 |
| Number of employers contributing to the scheme | 2018-07-01 | 0 |
| 2017: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 386 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 365 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
| Total of all active and inactive participants | 2017-07-01 | 365 |
| 2016: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 387 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 386 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
| Total of all active and inactive participants | 2016-07-01 | 386 |
| 2015: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 407 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 387 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 0 |
| Total of all active and inactive participants | 2015-07-01 | 387 |
| 2014: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 406 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 407 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
| Total of all active and inactive participants | 2014-07-01 | 407 |
| 2013: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 418 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 406 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 0 |
| Total of all active and inactive participants | 2013-07-01 | 406 |
| 2012: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 481 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 418 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 0 |
| Total of all active and inactive participants | 2012-07-01 | 418 |
| 2011: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 416 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 481 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-07-01 | 0 |
| Total of all active and inactive participants | 2011-07-01 | 481 |
| 2007: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-07-01 | 494 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-07-01 | 466 |
| Number of retired or separated participants receiving benefits | 2007-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-07-01 | 0 |
| Total of all active and inactive participants | 2007-07-01 | 466 |
| 2006: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-07-01 | 432 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-07-01 | 494 |
| Number of retired or separated participants receiving benefits | 2006-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2006-07-01 | 0 |
| Total of all active and inactive participants | 2006-07-01 | 494 |
| 2005: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-07-01 | 371 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-07-01 | 432 |
| Number of retired or separated participants receiving benefits | 2005-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2005-07-01 | 0 |
| Total of all active and inactive participants | 2005-07-01 | 432 |
| 2004: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-07-01 | 332 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-07-01 | 371 |
| Number of retired or separated participants receiving benefits | 2004-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2004-07-01 | 0 |
| Total of all active and inactive participants | 2004-07-01 | 371 |
| 2003: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2003 401k membership |
|---|
| Total participants, beginning-of-year | 2003-07-01 | 265 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-07-01 | 332 |
| Number of retired or separated participants receiving benefits | 2003-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2003-07-01 | 0 |
| Total of all active and inactive participants | 2003-07-01 | 332 |
| 2002: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2002 401k membership |
|---|
| Total participants, beginning-of-year | 2002-07-01 | 313 |
| Total number of active participants reported on line 7a of the Form 5500 | 2002-07-01 | 265 |
| Number of retired or separated participants receiving benefits | 2002-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2002-07-01 | 0 |
| Total of all active and inactive participants | 2002-07-01 | 265 |
| 2001: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2001 401k membership |
|---|
| Total participants, beginning-of-year | 2001-07-01 | 337 |
| Total number of active participants reported on line 7a of the Form 5500 | 2001-07-01 | 363 |
| Number of retired or separated participants receiving benefits | 2001-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2001-07-01 | 0 |
| Total of all active and inactive participants | 2001-07-01 | 363 |
| 2000: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2000 401k membership |
|---|
| Total participants, beginning-of-year | 2000-07-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2000-07-01 | 337 |
| Number of retired or separated participants receiving benefits | 2000-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2000-07-01 | 0 |
| Total of all active and inactive participants | 2000-07-01 | 337 |
| 2018: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2018 form 5500 responses |
|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | This submission is the final filing | Yes |
| 2018-07-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2007 form 5500 responses |
|---|
| 2007-07-01 | Type of plan entity | Single employer plan |
| 2007-07-01 | Plan funding arrangement – Insurance | Yes |
| 2007-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2006 form 5500 responses |
|---|
| 2006-07-01 | Type of plan entity | Single employer plan |
| 2006-07-01 | Plan funding arrangement – Insurance | Yes |
| 2006-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2005 form 5500 responses |
|---|
| 2005-07-01 | Type of plan entity | Single employer plan |
| 2005-07-01 | Plan funding arrangement – Insurance | Yes |
| 2005-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2004 form 5500 responses |
|---|
| 2004-07-01 | Type of plan entity | Single employer plan |
| 2004-07-01 | Plan funding arrangement – Insurance | Yes |
| 2004-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2003: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2003 form 5500 responses |
|---|
| 2003-07-01 | Type of plan entity | Single employer plan |
| 2003-07-01 | Plan funding arrangement – Insurance | Yes |
| 2003-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2002: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2002 form 5500 responses |
|---|
| 2002-07-01 | Type of plan entity | Single employer plan |
| 2002-07-01 | Plan funding arrangement – Insurance | Yes |
| 2002-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2001: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2001 form 5500 responses |
|---|
| 2001-07-01 | Type of plan entity | Single employer plan |
| 2001-07-01 | Plan funding arrangement – Insurance | Yes |
| 2001-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2000: BUILDERS TRANSPORTATION COMPANY, LLC MEDICAL PLAN 2000 form 5500 responses |
|---|
| 2000-07-01 | Type of plan entity | Single employer plan |
| 2000-07-01 | First time form 5500 has been submitted | Yes |
| 2000-07-01 | Plan funding arrangement – Insurance | Yes |
| 2000-07-01 | Plan benefit arrangement – Insurance | Yes |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 622842 |
| Policy instance | 1 |
| Insurance contract or identification number | 622842 | | Number of Individuals Covered | 290 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $3,203 | | Total amount of fees paid to insurance company | USD $25,618 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Welfare Benefit Premiums Paid to Carrier | USD $850,060 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $865 | | Amount paid for insurance broker fees | 25618 | | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEE | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 365 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $61,598 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,387 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $61,598 | | Insurance broker organization code? | 4 | | Insurance broker name | ORMA R SMITH |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 387 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $62,552 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,819 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $62,552 | | Insurance broker organization code? | 3 | | Insurance broker name | CRAIG WRIGHT |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 407 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $61,431 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,496 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $61,431 | | Insurance broker organization code? | 3 | | Insurance broker name | CRAIG WRIGHT |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 406 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $52,380 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,596 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $52,380 | | Insurance broker organization code? | 3 | | Insurance broker name | CRAIG WRIGHT |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 418 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $69,139 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $68,132 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $69,139 | | Insurance broker organization code? | 3 | | Insurance broker name | JAMES WRIGHT |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 481 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $59,670 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,702 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 416 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $52,544 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,270 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 481 | | Insurance policy start date | 2009-07-01 | | Insurance policy end date | 2010-06-30 | | Total amount of commissions paid to insurance broker | USD $54,167 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $54,167 | | Insurance broker organization code? | 3 | | Insurance broker name | GARLAND & ASSOCIATES |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 408 | | Insurance policy start date | 2008-07-01 | | Insurance policy end date | 2009-06-30 | | Total amount of commissions paid to insurance broker | USD $48,167 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,437 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $48,167 | | Insurance broker organization code? | 3 | | Insurance broker name | GARLAND & ASSOC. |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 466 | | Insurance policy start date | 2007-07-01 | | Insurance policy end date | 2008-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,253 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 494 | | Insurance policy start date | 2006-07-01 | | Insurance policy end date | 2007-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,313 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 432 | | Insurance policy start date | 2005-07-01 | | Insurance policy end date | 2006-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,335 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 371 | | Insurance policy start date | 2004-07-01 | | Insurance policy end date | 2005-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 332 | | Insurance policy start date | 2003-07-01 | | Insurance policy end date | 2004-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,997 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 265 | | Insurance policy start date | 2002-07-01 | | Insurance policy end date | 2003-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $365 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 2 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2001-07-01 | | Insurance policy end date | 2002-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 363 | | Insurance policy start date | 2001-07-01 | | Insurance policy end date | 2002-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $79,104 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 98597 |
| Policy instance | 1 |
| Insurance contract or identification number | 98597 | | Number of Individuals Covered | 337 | | Insurance policy start date | 2000-07-01 | | Insurance policy end date | 2001-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $79,939 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
