SELECTQUOTE INSURANCE SERVICES has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN
401k plan membership statisitcs for SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN
| Measure | Date | Value |
|---|
| 2022: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 7,422 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 4,161 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 76 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 4,237 |
| 2021: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 3,633 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 7,369 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 45 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 7,414 |
| 2020: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 2,126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 3,286 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 347 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 3,633 |
| 2019: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 1,296 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 2,109 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 17 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 2,126 |
| 2018: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 983 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 1,281 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 10 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 1,291 |
| 2011: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 315 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 367 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 6 |
| 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 | 373 |
| 2009: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 236 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 240 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 0 |
| Total of all active and inactive participants | 2009-07-01 | 243 |
| 2022: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SELECTQUOTE INSURANCE SERVICES GROUP WELFARE PLAN 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
| Policy contract number | 53715 |
| Policy instance | 3 |
| Insurance contract or identification number | 53715 | | Number of Individuals Covered | 2836 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $9,211 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $322,421 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,211 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 804324G |
| Policy instance | 2 |
| Insurance contract or identification number | 804324G | | Number of Individuals Covered | 4161 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $172,585 | | Total amount of fees paid to insurance company | USD $79,550 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,725,850 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $172,585 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 79550 | | Additional information about fees paid to insurance broker | FEES BONUS PAID |
|
| NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 ) |
| Policy contract number | EAP |
| Policy instance | 1 |
| Insurance contract or identification number | EAP | | Number of Individuals Covered | 3544 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $78,252 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 804324G |
| Policy instance | 2 |
| Insurance contract or identification number | 804324G | | Number of Individuals Covered | 7369 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $94,144 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $941,441 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $94,144 | | Insurance broker organization code? | 3 |
|
| SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
| Policy contract number | 53715 |
| Policy instance | 3 |
| Insurance contract or identification number | 53715 | | Number of Individuals Covered | 4157 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,950 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $294,356 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,950 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPS 326785 |
| Policy instance | 4 |
| Insurance contract or identification number | VPS 326785 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $496 | | Total amount of fees paid to insurance company | USD $80 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,305 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $380 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 80 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPL 301833 |
| Policy instance | 5 |
| Insurance contract or identification number | VPL 301833 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $670 | | Total amount of fees paid to insurance company | USD $116 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,468 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $554 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 116 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VG 185053 |
| Policy instance | 6 |
| Insurance contract or identification number | VG 185053 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $329 | | Total amount of fees paid to insurance company | USD $54 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $2,192 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $248 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 54 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES |
|
| NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 ) |
| Policy contract number | EAP |
| Policy instance | 1 |
| Insurance contract or identification number | EAP | | Number of Individuals Covered | 3544 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $58,122 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30080769 |
| Policy instance | 6 |
| Insurance contract or identification number | 30080769 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $936 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,731 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $936 | | Insurance broker organization code? | 3 |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1086581 |
| Policy instance | 5 |
| Insurance contract or identification number | 1086581 | | Number of Individuals Covered | 419 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $4,669 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,831 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,669 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
| Policy contract number | 53715 |
| Policy instance | 4 |
| Insurance contract or identification number | 53715 | | Number of Individuals Covered | 2414 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $37,121 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,248,049 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,121 | | Insurance broker organization code? | 3 |
|
| SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
| Policy contract number | 53715 |
| Policy instance | 3 |
| Insurance contract or identification number | 53715 | | Number of Individuals Covered | 2213 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $4,309 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $167,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,309 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 804324G |
| Policy instance | 2 |
| Insurance contract or identification number | 804324G | | Number of Individuals Covered | 3286 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $52,321 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $523,213 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $52,321 | | Insurance broker organization code? | 3 |
|
| NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 ) |
| Policy contract number | EAP |
| Policy instance | 1 |
| Insurance contract or identification number | EAP | | Number of Individuals Covered | 1732 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $31,730 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0890959 |
| Policy instance | 2 |
| Insurance contract or identification number | 0890959 | | Number of Individuals Covered | 2109 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $38,845 | | Total amount of fees paid to insurance company | USD $6,870 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $381,517 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $38,845 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6870 | | Additional information about fees paid to insurance broker | 2018 PPP ENGAGEMENT DENTAL RETENTION |
|
| SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
| Policy contract number | 53715 |
| Policy instance | 3 |
| Insurance contract or identification number | 53715 | | Number of Individuals Covered | 1513 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,634 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,057 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,634 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
| Policy contract number | 53715 |
| Policy instance | 4 |
| Insurance contract or identification number | 53715 | | Number of Individuals Covered | 1653 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $16,757 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $800,842 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,757 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 43239000 |
| Policy instance | 1 |
| Insurance contract or identification number | 43239000 | | Number of Individuals Covered | 2282 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $43,440 | | Total amount of fees paid to insurance company | USD $155,501 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,687,958 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,440 | | Amount paid for insurance broker fees | 155501 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES OTHER NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 ) |
| Policy contract number | 15354 |
| Policy instance | 3 |
| Insurance contract or identification number | 15354 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $63 | | Total amount of fees paid to insurance company | USD $119 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $322,135 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $63 | | Amount paid for insurance broker fees | 59 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 230420 |
| Policy instance | 1 |
| Insurance contract or identification number | 230420 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $8,965 | | Total amount of fees paid to insurance company | USD $496 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $402,166 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,608 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 496 | | Additional information about fees paid to insurance broker | BONUS |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95490 ) |
| Policy contract number | 0890959HNO |
| Policy instance | 4 |
| Insurance contract or identification number | 0890959HNO | | Number of Individuals Covered | 501 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $77,596 | | Welfare Benefit Premiums Paid to Carrier | USD $3,675,001 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,417 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0890959 |
| Policy instance | 5 |
| Insurance contract or identification number | 0890959 | | Number of Individuals Covered | 1281 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $95,414 | | Total amount of fees paid to insurance company | USD $2,393 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $3,728,411 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,554 | | Amount paid for insurance broker fees | 2393 | | Additional information about fees paid to insurance broker | 2017 PPP ENGAGEMENT CREDIT DENTAL RETENTION | | Insurance broker organization code? | 3 |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | 292-061 |
| Policy instance | 6 |
| Insurance contract or identification number | 292-061 | | Number of Individuals Covered | 641 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $5,166 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $74,665 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,444 | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 17381 |
| Policy instance | 2 |
| Insurance contract or identification number | 17381 | | Number of Individuals Covered | 125 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $19,428 | | Total amount of fees paid to insurance company | USD $910 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $852,416 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,551 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 910 | | Additional information about fees paid to insurance broker | BONUS |
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