WHITE RIVER HEALTH SYSTEM, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN
401k plan membership statisitcs for WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN
| Measure | Date | Value |
|---|
| 2022: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 1,455 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 1,514 |
| Total of all active and inactive participants | 2022-01-01 | 1,514 |
| 2021: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 1,427 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 1,455 |
| Total of all active and inactive participants | 2021-01-01 | 1,455 |
| 2020: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 1,522 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 1,427 |
| Total of all active and inactive participants | 2020-01-01 | 1,427 |
| 2019: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 1,568 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 1,522 |
| Total of all active and inactive participants | 2019-01-01 | 1,522 |
| 2018: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 1,477 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 1,568 |
| Total of all active and inactive participants | 2018-01-01 | 1,568 |
| 2017: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 1,419 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 1,477 |
| Total of all active and inactive participants | 2017-01-01 | 1,477 |
| 2016: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 1,272 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 1,419 |
| Total of all active and inactive participants | 2016-01-01 | 1,419 |
| 2015: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 1,230 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 1,272 |
| Total of all active and inactive participants | 2015-07-01 | 1,272 |
| Total participants, beginning-of-year | 2015-04-01 | 1,209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 1,230 |
| Total of all active and inactive participants | 2015-04-01 | 1,230 |
| 2014: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 1,173 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 1,209 |
| Total of all active and inactive participants | 2014-04-01 | 1,209 |
| 2013: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 1,205 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 1,173 |
| Total of all active and inactive participants | 2013-04-01 | 1,173 |
| 2012: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 1,213 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 1,205 |
| Total of all active and inactive participants | 2012-04-01 | 1,205 |
| 2011: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 1,330 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 1,213 |
| Total of all active and inactive participants | 2011-04-01 | 1,213 |
| 2010: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-04-01 | 1,260 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-04-01 | 1,330 |
| Total of all active and inactive participants | 2010-04-01 | 1,330 |
| 2009: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 1,175 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 1,260 |
| Total of all active and inactive participants | 2009-04-01 | 1,260 |
| 2008: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-09-01 | 940 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-09-01 | 1,175 |
| Total of all active and inactive participants | 2008-09-01 | 1,175 |
| 2007: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-09-01 | 940 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-09-01 | 940 |
| Total of all active and inactive participants | 2007-09-01 | 940 |
| 2006: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-09-01 | 940 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-09-01 | 940 |
| Total of all active and inactive participants | 2006-09-01 | 940 |
| 2005: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-09-01 | 940 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-09-01 | 940 |
| Total of all active and inactive participants | 2005-09-01 | 940 |
| 2022: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D 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 benefit arrangement – Insurance | Yes |
| 2021: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D 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 benefit arrangement – Insurance | Yes |
| 2019: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D 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 benefit arrangement – Insurance | Yes |
| 2018: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-04-01 | Type of plan entity | Single employer plan |
| 2015-04-01 | Submission has been amended | No |
| 2015-04-01 | This submission is the final filing | No |
| 2015-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-04-01 | Plan is a collectively bargained plan | No |
| 2015-04-01 | Plan funding arrangement – Insurance | Yes |
| 2015-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2014 form 5500 responses |
|---|
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | Submission has been amended | No |
| 2014-04-01 | This submission is the final filing | No |
| 2014-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-04-01 | Plan is a collectively bargained plan | No |
| 2014-04-01 | Plan funding arrangement – Insurance | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2013 form 5500 responses |
|---|
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | Submission has been amended | No |
| 2013-04-01 | This submission is the final filing | No |
| 2013-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-04-01 | Plan is a collectively bargained plan | No |
| 2013-04-01 | Plan funding arrangement – Insurance | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2012 form 5500 responses |
|---|
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Submission has been amended | No |
| 2012-04-01 | This submission is the final filing | No |
| 2012-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-04-01 | Plan is a collectively bargained plan | No |
| 2012-04-01 | Plan funding arrangement – Insurance | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Submission has been amended | No |
| 2011-04-01 | This submission is the final filing | No |
| 2011-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-04-01 | Plan is a collectively bargained plan | No |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2010 form 5500 responses |
|---|
| 2010-04-01 | Type of plan entity | Single employer plan |
| 2010-04-01 | Submission has been amended | No |
| 2010-04-01 | This submission is the final filing | No |
| 2010-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-04-01 | Plan is a collectively bargained plan | No |
| 2010-04-01 | Plan funding arrangement – Insurance | Yes |
| 2010-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2009 form 5500 responses |
|---|
| 2009-04-01 | Type of plan entity | Single employer plan |
| 2009-04-01 | Submission has been amended | No |
| 2009-04-01 | This submission is the final filing | No |
| 2009-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-04-01 | Plan is a collectively bargained plan | No |
| 2009-04-01 | Plan funding arrangement – Insurance | Yes |
| 2009-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2008 form 5500 responses |
|---|
| 2008-09-01 | Type of plan entity | Single employer plan |
| 2008-09-01 | Submission has been amended | No |
| 2008-09-01 | This submission is the final filing | No |
| 2008-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2008-09-01 | Plan is a collectively bargained plan | No |
| 2008-09-01 | Plan funding arrangement – Insurance | Yes |
| 2008-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2007 form 5500 responses |
|---|
| 2007-09-01 | Type of plan entity | Single employer plan |
| 2007-09-01 | Submission has been amended | No |
| 2007-09-01 | This submission is the final filing | No |
| 2007-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-09-01 | Plan is a collectively bargained plan | No |
| 2007-09-01 | Plan funding arrangement – Insurance | Yes |
| 2007-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2006 form 5500 responses |
|---|
| 2006-09-01 | Type of plan entity | Single employer plan |
| 2006-09-01 | Submission has been amended | No |
| 2006-09-01 | This submission is the final filing | No |
| 2006-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-09-01 | Plan is a collectively bargained plan | No |
| 2006-09-01 | Plan funding arrangement – Insurance | Yes |
| 2006-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: WHITE RIVER HEALTH SYSTEM GROUP LIFE AND AD&D PLAN 2005 form 5500 responses |
|---|
| 2005-09-01 | Type of plan entity | Single employer plan |
| 2005-09-01 | Submission has been amended | No |
| 2005-09-01 | This submission is the final filing | No |
| 2005-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-09-01 | Plan is a collectively bargained plan | No |
| 2005-09-01 | Plan funding arrangement – Insurance | Yes |
| 2005-09-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 768664G |
| Policy instance | 1 |
| Insurance contract or identification number | 768664G | | Number of Individuals Covered | 1514 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $21,890 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $195,447 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,890 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 768664G |
| Policy instance | 1 |
| Insurance contract or identification number | 768664G | | Number of Individuals Covered | 1455 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $16,230 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $144,907 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,230 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 768664G |
| Policy instance | 1 |
| Insurance contract or identification number | 768664G | | Number of Individuals Covered | 1427 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $15,417 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $137,653 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,417 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010205487 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010205487 | | Number of Individuals Covered | 1522 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $14,672 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $146,725 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,672 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010205487 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010205487 | | Number of Individuals Covered | 1568 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $14,213 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $142,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,213 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010205487 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010205487 | | Number of Individuals Covered | 1477 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $13,830 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $138,302 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66598-3 |
| Policy instance | 1 |
| Insurance contract or identification number | 66598-3 | | Number of Individuals Covered | 3990 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $10,999 | | Total amount of fees paid to insurance company | USD $2,511 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $109,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,249 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2511 | | Additional information about fees paid to insurance broker | SUPP. COMPENSATION | | Insurance broker name | PREMIER INSURANCE MANAGEMENT |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66598-3 |
| Policy instance | 1 |
| Insurance contract or identification number | 66598-3 | | Number of Individuals Covered | 3871 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $12,326 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $111,869 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,390 | | Insurance broker organization code? | 3 | | Insurance broker name | PREMIER INSURANCE MANAGEMENT |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66598-3 |
| Policy instance | 1 |
| Insurance contract or identification number | 66598-3 | | Number of Individuals Covered | 4218 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $11,321 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $113,208 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,491 | | Insurance broker organization code? | 3 | | Insurance broker name | WORKPLACE SOLUTIONS, INC. |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66598-3 |
| Policy instance | 1 |
| Insurance contract or identification number | 66598-3 | | Number of Individuals Covered | 4246 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $11,433 | | Total amount of fees paid to insurance company | USD $1,114 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $114,331 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,575 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1114 | | Additional information about fees paid to insurance broker | SUPP. COMPENSATION | | Insurance broker name | PREMIER INSURANCE MANAGEMENT |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66598-3 |
| Policy instance | 1 |
| Insurance contract or identification number | 66598-3 | | Number of Individuals Covered | 4655 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $10,864 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $108,639 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,148 | | Insurance broker organization code? | 3 | | Insurance broker name | WORKPLACE SOLUTIONS, INC. |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66598-3 |
| Policy instance | 1 |
| Insurance contract or identification number | 66598-3 | | Number of Individuals Covered | 4410 | | Insurance policy start date | 2009-04-01 | | Insurance policy end date | 2010-03-31 | | Total amount of commissions paid to insurance broker | USD $10,518 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $105,176 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,888 | | Insurance broker organization code? | 3 | | Insurance broker name | WORKPLACE SOLUTIONS, INC. |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 549211 |
| Policy instance | 1 |
| Insurance contract or identification number | 549211 | | Number of Individuals Covered | 1175 | | Insurance policy start date | 2008-09-01 | | Insurance policy end date | 2009-03-31 | | Total amount of commissions paid to insurance broker | USD $2,927 | | Total amount of fees paid to insurance company | USD $224 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $25,210 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,463 | | Amount paid for insurance broker fees | 77 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | | Insurance broker organization code? | 3 | | Insurance broker name | WORKPLACE SOLUTIONS INC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 549211 |
| Policy instance | 1 |
| Insurance contract or identification number | 549211 | | Insurance policy start date | 2007-09-01 | | Insurance policy end date | 2008-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 549211 |
| Policy instance | 1 |
| Insurance contract or identification number | 549211 | | Insurance policy start date | 2006-09-01 | | Insurance policy end date | 2007-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 549211 |
| Policy instance | 1 |
| Insurance contract or identification number | 549211 | | Insurance policy start date | 2005-09-01 | | Insurance policy end date | 2006-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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