EXPRESS OIL CHANGE, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN
Measure | Date | Value |
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2022: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-07-01 | 2,170 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 2,466 |
Number of retired or separated participants receiving benefits | 2022-07-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
Total of all active and inactive participants | 2022-07-01 | 2,468 |
2021: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-07-01 | 1,293 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 1,987 |
Number of retired or separated participants receiving benefits | 2021-07-01 | 6 |
Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
Total of all active and inactive participants | 2021-07-01 | 1,993 |
2020: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-07-01 | 798 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 1,293 |
Number of retired or separated participants receiving benefits | 2020-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-07-01 | 0 |
Total of all active and inactive participants | 2020-07-01 | 1,293 |
2019: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-11-01 | 658 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-11-01 | 791 |
Number of retired or separated participants receiving benefits | 2019-11-01 | 7 |
Number of other retired or separated participants entitled to future benefits | 2019-11-01 | 0 |
Total of all active and inactive participants | 2019-11-01 | 798 |
2018: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-11-01 | 568 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 506 |
Number of retired or separated participants receiving benefits | 2018-11-01 | 11 |
Number of other retired or separated participants entitled to future benefits | 2018-11-01 | 0 |
Total of all active and inactive participants | 2018-11-01 | 517 |
2017: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-11-01 | 804 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 543 |
Number of retired or separated participants receiving benefits | 2017-11-01 | 17 |
Number of other retired or separated participants entitled to future benefits | 2017-11-01 | 0 |
Total of all active and inactive participants | 2017-11-01 | 560 |
2016: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-11-01 | 866 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 979 |
Number of retired or separated participants receiving benefits | 2016-11-01 | 5 |
Number of other retired or separated participants entitled to future benefits | 2016-11-01 | 0 |
Total of all active and inactive participants | 2016-11-01 | 984 |
2015: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-11-01 | 1,216 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-11-01 | 868 |
Number of retired or separated participants receiving benefits | 2015-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-11-01 | 0 |
Total of all active and inactive participants | 2015-11-01 | 868 |
2014: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-11-01 | 353 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-11-01 | 1,216 |
Number of retired or separated participants receiving benefits | 2014-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-11-01 | 0 |
Total of all active and inactive participants | 2014-11-01 | 1,216 |
2013: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-11-01 | 536 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-11-01 | 353 |
Number of retired or separated participants receiving benefits | 2013-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-11-01 | 0 |
Total of all active and inactive participants | 2013-11-01 | 353 |
2012: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-11-01 | 536 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-11-01 | 536 |
Number of retired or separated participants receiving benefits | 2012-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-11-01 | 0 |
Total of all active and inactive participants | 2012-11-01 | 536 |
2011: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-11-01 | 536 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-11-01 | 536 |
Number of retired or separated participants receiving benefits | 2011-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-11-01 | 0 |
Total of all active and inactive participants | 2011-11-01 | 536 |
2010: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-11-01 | 356 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-11-01 | 309 |
Number of retired or separated participants receiving benefits | 2010-11-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2010-11-01 | 0 |
Total of all active and inactive participants | 2010-11-01 | 310 |
2009: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-11-01 | 447 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-11-01 | 354 |
Number of retired or separated participants receiving benefits | 2009-11-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2009-11-01 | 0 |
Total of all active and inactive participants | 2009-11-01 | 356 |
2008: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2008 401k membership |
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Total participants, beginning-of-year | 2008-11-01 | 326 |
Total number of active participants reported on line 7a of the Form 5500 | 2008-11-01 | 599 |
Number of retired or separated participants receiving benefits | 2008-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2008-11-01 | 0 |
Total of all active and inactive participants | 2008-11-01 | 599 |
Total participants, beginning-of-year | 2008-10-01 | 326 |
Total number of active participants reported on line 7a of the Form 5500 | 2008-10-01 | 326 |
Number of retired or separated participants receiving benefits | 2008-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2008-10-01 | 0 |
Total of all active and inactive participants | 2008-10-01 | 326 |
2007: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2007 401k membership |
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Total participants, beginning-of-year | 2007-10-01 | 318 |
Total number of active participants reported on line 7a of the Form 5500 | 2007-10-01 | 326 |
Number of retired or separated participants receiving benefits | 2007-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2007-10-01 | 0 |
Total of all active and inactive participants | 2007-10-01 | 326 |
2006: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2006 401k membership |
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Total participants, beginning-of-year | 2006-10-01 | 316 |
Total number of active participants reported on line 7a of the Form 5500 | 2006-10-01 | 318 |
Number of retired or separated participants receiving benefits | 2006-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2006-10-01 | 0 |
Total of all active and inactive participants | 2006-10-01 | 318 |
2005: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2005 401k membership |
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Total participants, beginning-of-year | 2005-10-01 | 265 |
Total number of active participants reported on line 7a of the Form 5500 | 2005-10-01 | 316 |
Number of retired or separated participants receiving benefits | 2005-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2005-10-01 | 0 |
Total of all active and inactive participants | 2005-10-01 | 316 |
2004: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2004 401k membership |
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Total participants, beginning-of-year | 2004-10-01 | 311 |
Total number of active participants reported on line 7a of the Form 5500 | 2004-10-01 | 265 |
Number of retired or separated participants receiving benefits | 2004-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2004-10-01 | 0 |
Total of all active and inactive participants | 2004-10-01 | 265 |
2003: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2003 401k membership |
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Total participants, beginning-of-year | 2003-10-01 | 340 |
Total number of active participants reported on line 7a of the Form 5500 | 2003-10-01 | 311 |
Number of retired or separated participants receiving benefits | 2003-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2003-10-01 | 0 |
Total of all active and inactive participants | 2003-10-01 | 311 |
2002: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2002 401k membership |
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Total participants, beginning-of-year | 2002-10-01 | 263 |
Total number of active participants reported on line 7a of the Form 5500 | 2002-10-01 | 340 |
Number of retired or separated participants receiving benefits | 2002-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2002-10-01 | 0 |
Total of all active and inactive participants | 2002-10-01 | 340 |
Total participants, beginning-of-year | 2002-09-01 | 263 |
Total number of active participants reported on line 7a of the Form 5500 | 2002-09-01 | 263 |
Number of retired or separated participants receiving benefits | 2002-09-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2002-09-01 | 0 |
Total of all active and inactive participants | 2002-09-01 | 263 |
2000: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2000 401k membership |
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Total number of active participants reported on line 7a of the Form 5500 | 2000-09-01 | 267 |
Number of retired or separated participants receiving benefits | 2000-09-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2000-09-01 | 0 |
Total of all active and inactive participants | 2000-09-01 | 267 |
1999: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 1999 401k membership |
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Total participants, beginning-of-year | 1999-09-01 | 261 |
Total number of active participants reported on line 7a of the Form 5500 | 1999-09-01 | 273 |
Number of retired or separated participants receiving benefits | 1999-09-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 1999-09-01 | 0 |
Total of all active and inactive participants | 1999-09-01 | 273 |
1998: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 1998 401k membership |
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Total participants, beginning-of-year | 1998-09-01 | 261 |
Total number of active participants reported on line 7a of the Form 5500 | 1998-09-01 | 261 |
Number of retired or separated participants receiving benefits | 1998-09-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 1998-09-01 | 0 |
Total of all active and inactive participants | 1998-09-01 | 261 |
2022: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2022 form 5500 responses |
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2022-07-01 | Type of plan entity | Single employer plan |
2022-07-01 | Submission has been amended | No |
2022-07-01 | This submission is the final filing | No |
2022-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-07-01 | Plan is a collectively bargained plan | No |
2022-07-01 | Plan funding arrangement – Insurance | Yes |
2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-07-01 | Plan benefit arrangement – Insurance | Yes |
2022-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2021 form 5500 responses |
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2021-07-01 | Type of plan entity | Single employer plan |
2021-07-01 | Submission has been amended | No |
2021-07-01 | This submission is the final filing | No |
2021-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-07-01 | Plan is a collectively bargained plan | No |
2021-07-01 | Plan funding arrangement – Insurance | Yes |
2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-07-01 | Plan benefit arrangement – Insurance | Yes |
2021-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2020 form 5500 responses |
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2020-07-01 | Type of plan entity | Single employer plan |
2020-07-01 | Submission has been amended | No |
2020-07-01 | This submission is the final filing | No |
2020-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-07-01 | Plan is a collectively bargained plan | No |
2020-07-01 | Plan funding arrangement – Insurance | Yes |
2020-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-07-01 | Plan benefit arrangement – Insurance | Yes |
2020-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2019 form 5500 responses |
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2019-11-01 | Type of plan entity | Single employer plan |
2019-11-01 | Submission has been amended | No |
2019-11-01 | This submission is the final filing | No |
2019-11-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2019-11-01 | Plan is a collectively bargained plan | No |
2019-11-01 | Plan funding arrangement – Insurance | Yes |
2019-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-11-01 | Plan benefit arrangement – Insurance | Yes |
2019-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2018 form 5500 responses |
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2018-11-01 | Type of plan entity | Single employer plan |
2018-11-01 | Submission has been amended | No |
2018-11-01 | This submission is the final filing | No |
2018-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-11-01 | Plan is a collectively bargained plan | No |
2018-11-01 | Plan funding arrangement – Insurance | Yes |
2018-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-11-01 | Plan benefit arrangement – Insurance | Yes |
2018-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2017 form 5500 responses |
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2017-11-01 | Type of plan entity | Single employer plan |
2017-11-01 | Submission has been amended | No |
2017-11-01 | This submission is the final filing | No |
2017-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-11-01 | Plan is a collectively bargained plan | No |
2017-11-01 | Plan funding arrangement – Insurance | Yes |
2017-11-01 | Plan benefit arrangement – Insurance | Yes |
2016: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2016 form 5500 responses |
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2016-11-01 | Type of plan entity | Single employer plan |
2016-11-01 | Submission has been amended | No |
2016-11-01 | This submission is the final filing | No |
2016-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-11-01 | Plan is a collectively bargained plan | No |
2016-11-01 | Plan funding arrangement – Insurance | Yes |
2016-11-01 | Plan benefit arrangement – Insurance | Yes |
2015: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2015 form 5500 responses |
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2015-11-01 | Type of plan entity | Single employer plan |
2015-11-01 | Submission has been amended | No |
2015-11-01 | This submission is the final filing | No |
2015-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-11-01 | Plan is a collectively bargained plan | No |
2015-11-01 | Plan funding arrangement – Insurance | Yes |
2015-11-01 | Plan benefit arrangement – Insurance | Yes |
2014: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2014 form 5500 responses |
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2014-11-01 | Type of plan entity | Single employer plan |
2014-11-01 | Submission has been amended | No |
2014-11-01 | This submission is the final filing | No |
2014-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-11-01 | Plan is a collectively bargained plan | No |
2014-11-01 | Plan funding arrangement – Insurance | Yes |
2014-11-01 | Plan benefit arrangement – Insurance | Yes |
2013: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2013 form 5500 responses |
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2013-11-01 | Type of plan entity | Single employer plan |
2013-11-01 | Submission has been amended | No |
2013-11-01 | This submission is the final filing | No |
2013-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-11-01 | Plan is a collectively bargained plan | No |
2013-11-01 | Plan funding arrangement – Insurance | Yes |
2013-11-01 | Plan benefit arrangement – Insurance | Yes |
2012: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2012 form 5500 responses |
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2012-11-01 | Type of plan entity | Single employer plan |
2012-11-01 | Submission has been amended | No |
2012-11-01 | This submission is the final filing | No |
2012-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-11-01 | Plan is a collectively bargained plan | No |
2012-11-01 | Plan funding arrangement – Insurance | Yes |
2012-11-01 | Plan benefit arrangement – Insurance | Yes |
2011: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2011 form 5500 responses |
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2011-11-01 | Type of plan entity | Single employer plan |
2011-11-01 | Submission has been amended | No |
2011-11-01 | This submission is the final filing | No |
2011-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-11-01 | Plan is a collectively bargained plan | No |
2011-11-01 | Plan funding arrangement – Insurance | Yes |
2011-11-01 | Plan benefit arrangement – Insurance | Yes |
2010: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2010 form 5500 responses |
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2010-11-01 | Type of plan entity | Single employer plan |
2010-11-01 | Submission has been amended | No |
2010-11-01 | This submission is the final filing | No |
2010-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-11-01 | Plan is a collectively bargained plan | No |
2010-11-01 | Plan funding arrangement – Insurance | Yes |
2010-11-01 | Plan benefit arrangement – Insurance | Yes |
2009: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2009 form 5500 responses |
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2009-11-01 | Type of plan entity | Single employer plan |
2009-11-01 | Submission has been amended | No |
2009-11-01 | This submission is the final filing | No |
2009-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-11-01 | Plan is a collectively bargained plan | No |
2009-11-01 | Plan funding arrangement – Insurance | Yes |
2009-11-01 | Plan benefit arrangement – Insurance | Yes |
2008: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2008 form 5500 responses |
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2008-11-01 | Type of plan entity | Single employer plan |
2008-11-01 | Submission has been amended | No |
2008-11-01 | This submission is the final filing | No |
2008-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2008-11-01 | Plan is a collectively bargained plan | No |
2008-11-01 | Plan funding arrangement – Insurance | Yes |
2008-11-01 | Plan benefit arrangement – Insurance | Yes |
2008-10-01 | Type of plan entity | Single employer plan |
2008-10-01 | Submission has been amended | No |
2008-10-01 | This submission is the final filing | No |
2008-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2008-10-01 | Plan is a collectively bargained plan | No |
2008-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2008-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2007: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2007 form 5500 responses |
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2007-10-01 | Type of plan entity | Single employer plan |
2007-10-01 | Submission has been amended | No |
2007-10-01 | This submission is the final filing | No |
2007-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2007-10-01 | Plan is a collectively bargained plan | No |
2007-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2007-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2006: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2006 form 5500 responses |
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2006-10-01 | Type of plan entity | Single employer plan |
2006-10-01 | Submission has been amended | No |
2006-10-01 | This submission is the final filing | No |
2006-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2006-10-01 | Plan is a collectively bargained plan | No |
2006-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2006-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2005: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2005 form 5500 responses |
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2005-10-01 | Type of plan entity | Single employer plan |
2005-10-01 | Submission has been amended | No |
2005-10-01 | This submission is the final filing | No |
2005-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2005-10-01 | Plan is a collectively bargained plan | No |
2005-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2005-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2004: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2004 form 5500 responses |
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2004-10-01 | Type of plan entity | Single employer plan |
2004-10-01 | Submission has been amended | No |
2004-10-01 | This submission is the final filing | No |
2004-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2004-10-01 | Plan is a collectively bargained plan | No |
2004-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2004-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2003: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2003 form 5500 responses |
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2003-10-01 | Type of plan entity | Single employer plan |
2003-10-01 | Submission has been amended | No |
2003-10-01 | This submission is the final filing | No |
2003-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2003-10-01 | Plan is a collectively bargained plan | No |
2003-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2003-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2002: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2002 form 5500 responses |
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2002-10-01 | Type of plan entity | Single employer plan |
2002-10-01 | Submission has been amended | No |
2002-10-01 | This submission is the final filing | No |
2002-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2002-10-01 | Plan is a collectively bargained plan | No |
2002-10-01 | Plan funding arrangement – Insurance | Yes |
2002-10-01 | Plan benefit arrangement – Insurance | Yes |
2002-09-01 | Type of plan entity | Single employer plan |
2002-09-01 | Submission has been amended | No |
2002-09-01 | This submission is the final filing | No |
2002-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2002-09-01 | Plan is a collectively bargained plan | No |
2002-09-01 | Plan funding arrangement – Insurance | Yes |
2002-09-01 | Plan benefit arrangement – Insurance | Yes |
2000: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 2000 form 5500 responses |
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2000-09-01 | Type of plan entity | Single employer plan |
2000-09-01 | Submission has been amended | No |
2000-09-01 | This submission is the final filing | No |
2000-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2000-09-01 | Plan is a collectively bargained plan | No |
2000-09-01 | Plan funding arrangement – Insurance | Yes |
2000-09-01 | Plan benefit arrangement – Insurance | Yes |
1999: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 1999 form 5500 responses |
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1999-09-01 | Type of plan entity | Single employer plan |
1999-09-01 | Submission has been amended | No |
1999-09-01 | This submission is the final filing | No |
1999-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
1999-09-01 | Plan is a collectively bargained plan | No |
1999-09-01 | Plan funding arrangement – Insurance | Yes |
1999-09-01 | Plan benefit arrangement – Insurance | Yes |
1998: EXPRESS OIL CHANGE, LLC MEDICAL/DENTAL PLAN 1998 form 5500 responses |
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1998-09-01 | Type of plan entity | Single employer plan |
1998-09-01 | First time form 5500 has been submitted | Yes |
1998-09-01 | Submission has been amended | No |
1998-09-01 | This submission is the final filing | No |
1998-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
1998-09-01 | Plan is a collectively bargained plan | No |
1998-09-01 | Plan funding arrangement – Insurance | Yes |
1998-09-01 | Plan benefit arrangement – Insurance | Yes |
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
Policy contract number | 09196* |
Policy instance | 2 |
Insurance contract or identification number | 09196* | Number of Individuals Covered | 3733 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | G1059-38 |
Policy instance | 1 |
Insurance contract or identification number | G1059-38 | Number of Individuals Covered | 0 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Total amount of commissions paid to insurance broker | USD $119,216 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $492,166 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $53,499 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
Policy contract number | 09196* |
Policy instance | 2 |
Insurance contract or identification number | 09196* | Number of Individuals Covered | 3445 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | G1059-38 |
Policy instance | 1 |
Insurance contract or identification number | G1059-38 | Number of Individuals Covered | 0 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $117,177 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $483,753 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $52,584 | Insurance broker organization code? | 3 |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | G1059-38 |
Policy instance | 1 |
Insurance contract or identification number | G1059-38 | Number of Individuals Covered | 0 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $92,645 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $382,345 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $32,133 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
Policy contract number | 09196 |
Policy instance | 2 |
Insurance contract or identification number | 09196 | Number of Individuals Covered | 2300 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
Policy contract number | 37579 |
Policy instance | 1 |
Insurance contract or identification number | 37579 | Number of Individuals Covered | 1496 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-06-30 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | G1059-38 |
Policy instance | 2 |
Insurance contract or identification number | G1059-38 | Number of Individuals Covered | 0 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $36,857 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $219,177 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $23,838 | Insurance broker organization code? | 3 |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | G1059 |
Policy instance | 2 |
Insurance contract or identification number | G1059 | Number of Individuals Covered | 506 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $49,814 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $296,197 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,120 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
Policy contract number | 37579 |
Policy instance | 1 |
Insurance contract or identification number | 37579 | Number of Individuals Covered | 1243 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
Policy contract number | 37579 |
Policy instance | 2 |
Insurance contract or identification number | 37579 | Number of Individuals Covered | 1058 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
Policy contract number | 37579 |
Policy instance | 1 |
Insurance contract or identification number | 37579 | Number of Individuals Covered | 998 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2017-12-31 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
Policy contract number | 37579 |
Policy instance | 1 |
Insurance contract or identification number | 37579 | Number of Individuals Covered | 1216 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 715379 |
Policy instance | 1 |
Insurance contract or identification number | 715379 | Number of Individuals Covered | 830 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $85,642 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $2,834,046 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $85,620 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 715379 |
Policy instance | 1 |
Insurance contract or identification number | 715379 | Number of Individuals Covered | 536 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $72,556 | Total amount of fees paid to insurance company | USD $13,766 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $2,401,772 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $49,523 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 13766 | Additional information about fees paid to insurance broker | BONUS | Insurance broker name | LOCKTON COMPANIES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0715379 |
Policy instance | 1 |
Insurance contract or identification number | 0715379 | Number of Individuals Covered | 536 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $65,336 | Total amount of fees paid to insurance company | USD $21,285 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $2,165,600 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0715379 |
Policy instance | 1 |
Insurance contract or identification number | 0715379 | Number of Individuals Covered | 536 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $63,501 | Total amount of fees paid to insurance company | USD $20,281 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $2,415,366 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0715379 |
Policy instance | 1 |
Insurance contract or identification number | 0715379 | Number of Individuals Covered | 326 | Insurance policy start date | 2008-10-01 | Insurance policy end date | 2008-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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? | Yes |
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