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J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 401k Plan overview

Plan NameJ.D. YOUNG COMPANY WELFARE BENEFITS PLAN
Plan identification number 501

J.D. YOUNG COMPANY WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

J.D. YOUNG COMPANY has sponsored the creation of one or more 401k plans.

Company Name:J.D. YOUNG COMPANY
Employer identification number (EIN):730628766
NAIC Classification:423400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan J.D. YOUNG COMPANY WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-09-01ANDREA WILSON2024-02-19
5012021-09-01WALTER R. FABER2023-06-07
5012020-09-01
5012019-09-01
5012018-09-01
5012017-09-01
5012016-09-01HOGANTAYLOR LLP PREPARER
5012015-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2016-11-22
5012014-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2015-12-23
5012013-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2015-07-30
5012012-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2015-12-22
5012011-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2015-12-22
5012010-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2015-12-22
5012009-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2015-12-22
5012008-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2015-12-22

Plan Statistics for J.D. YOUNG COMPANY WELFARE BENEFITS PLAN

401k plan membership statisitcs for J.D. YOUNG COMPANY WELFARE BENEFITS PLAN

Measure Date Value
2022: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-09-01119
Total number of active participants reported on line 7a of the Form 55002022-09-01130
Total of all active and inactive participants2022-09-01130
2021: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01123
Total number of active participants reported on line 7a of the Form 55002021-09-01118
Number of retired or separated participants receiving benefits2021-09-011
Total of all active and inactive participants2021-09-01119
2020: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01109
Total number of active participants reported on line 7a of the Form 55002020-09-0199
Total of all active and inactive participants2020-09-0199
2019: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01108
Total number of active participants reported on line 7a of the Form 55002019-09-01109
Total of all active and inactive participants2019-09-01109
2018: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01116
Total number of active participants reported on line 7a of the Form 55002018-09-01119
Total of all active and inactive participants2018-09-01119
2017: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01111
Total number of active participants reported on line 7a of the Form 55002017-09-01112
Total of all active and inactive participants2017-09-01112
Total participants2017-09-01112
2016: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01115
Total number of active participants reported on line 7a of the Form 55002016-09-01112
Total of all active and inactive participants2016-09-01112
Total participants2016-09-01112
2015: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01143
Total number of active participants reported on line 7a of the Form 55002015-09-01146
Number of retired or separated participants receiving benefits2015-09-016
Total of all active and inactive participants2015-09-01152
Total participants2015-09-01152
2014: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01228
Total number of active participants reported on line 7a of the Form 55002014-09-01141
Number of retired or separated participants receiving benefits2014-09-012
Total of all active and inactive participants2014-09-01143
Total participants2014-09-01143
2013: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01199
Total number of active participants reported on line 7a of the Form 55002013-09-01228
Total of all active and inactive participants2013-09-01228
Total participants2013-09-01228
2012: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01174
Total number of active participants reported on line 7a of the Form 55002012-09-01196
Number of retired or separated participants receiving benefits2012-09-013
Total of all active and inactive participants2012-09-01199
Total participants2012-09-01199
2011: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01142
Total number of active participants reported on line 7a of the Form 55002011-09-01174
Total of all active and inactive participants2011-09-01174
Total participants2011-09-01174
2010: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-09-01147
Total number of active participants reported on line 7a of the Form 55002010-09-01142
Total of all active and inactive participants2010-09-01142
Total participants2010-09-01142
2009: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-01156
Total number of active participants reported on line 7a of the Form 55002009-09-01147
Total of all active and inactive participants2009-09-01147
Total participants2009-09-01147
2008: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year2008-09-01166
Total number of active participants reported on line 7a of the Form 55002008-09-01156
Total of all active and inactive participants2008-09-01156
Total participants2008-09-01156

Form 5500 Responses for J.D. YOUNG COMPANY WELFARE BENEFITS PLAN

2022: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01Submission has been amendedNo
2022-09-01This submission is the final filingNo
2022-09-01This return/report is a short plan year return/report (less than 12 months)No
2022-09-01Plan is a collectively bargained planNo
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan benefit arrangement – InsuranceYes
2021: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planNo
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)No
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)No
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2010: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2010 form 5500 responses
2010-09-01Type of plan entitySingle employer plan
2010-09-01Plan funding arrangement – InsuranceYes
2010-09-01Plan benefit arrangement – InsuranceYes
2009: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes
2008: J.D. YOUNG COMPANY WELFARE BENEFITS PLAN 2008 form 5500 responses
2008-09-01Type of plan entitySingle employer plan
2008-09-01Submission has been amendedNo
2008-09-01This submission is the final filingNo
2008-09-01This return/report is a short plan year return/report (less than 12 months)No
2008-09-01Plan is a collectively bargained planNo
2008-09-01Plan funding arrangement – InsuranceYes
2008-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 3
Insurance contract or identification number4121
Number of Individuals Covered93
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $4,527
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,527
Insurance broker organization code?3
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number54683
Policy instance 2
Insurance contract or identification number54683
Number of Individuals Covered129
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $6,500
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $47,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,500
Insurance broker organization code?3
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 1
Insurance contract or identification numberC09162
Number of Individuals Covered147
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of fees paid to insurance companyUSD $33,270
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $911,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees33270
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 1
Insurance contract or identification numberC09162
Number of Individuals Covered147
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of fees paid to insurance companyUSD $34,980
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $996,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees34980
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 2
Insurance contract or identification number4121
Number of Individuals Covered86
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $4,662
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,662
Insurance broker organization code?3
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number54683
Policy instance 3
Insurance contract or identification number54683
Number of Individuals Covered119
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $7,464
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $49,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,464
Insurance broker organization code?3
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 1
Insurance contract or identification number4121
Number of Individuals Covered93
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $4,410
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,410
Insurance broker organization code?3
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number54683
Policy instance 3
Insurance contract or identification number54683
Number of Individuals Covered125
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $7,136
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $47,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,136
Insurance broker organization code?3
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 2
Insurance contract or identification numberC09162
Number of Individuals Covered147
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of fees paid to insurance companyUSD $37,650
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $1,052,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees37650
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number54683
Policy instance 2
Insurance contract or identification number54683
Number of Individuals Covered141
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $3,044
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $24,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,044
Insurance broker organization code?3
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 1
Insurance contract or identification numberC09162
Number of Individuals Covered148
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of fees paid to insurance companyUSD $37,240
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $1,085,690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees37240
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 3
Insurance contract or identification number4121
Number of Individuals Covered100
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $4,673
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,673
Insurance broker organization code?3
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 2
Insurance contract or identification number4121
Number of Individuals Covered96
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $4,662
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,897
Insurance broker organization code?3
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number54683
Policy instance 1
Insurance contract or identification number54683
Number of Individuals Covered136
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $7,152
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $47,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,936
Insurance broker organization code?3
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 3
Insurance contract or identification numberC09162
Number of Individuals Covered151
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of fees paid to insurance companyUSD $22,627
Health Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,165,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees20825
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number54683
Policy instance 2
Insurance contract or identification number54683
Number of Individuals Covered137
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $6,948
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $46,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 1
Insurance contract or identification numberC09162
Number of Individuals Covered154
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of fees paid to insurance companyUSD $23,001
Health Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,225,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 3
Insurance contract or identification number4121
Number of Individuals Covered94
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $4,500
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 3
Insurance contract or identification number4121
Number of Individuals Covered100
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $4,077
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,077
Insurance broker organization code?3
Insurance broker nameJIM RULEY & CO INC
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 2
Insurance contract or identification numberC09162
Number of Individuals Covered169
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $24,191
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $1,113,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,191
Insurance broker organization code?3
Insurance broker nameJIM RULEY & CO. INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number238710
Policy instance 1
Insurance contract or identification number238710
Number of Individuals Covered139
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $5,940
Total amount of fees paid to insurance companyUSD $528
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $45,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,940
Amount paid for insurance broker fees528
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTH RISK PARTNERS, LLC
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 1
Insurance contract or identification number4121
Number of Individuals Covered128
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $5,221
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,221
Insurance broker organization code?3
Insurance broker nameJIM RULEY & CO INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number238710
Policy instance 3
Insurance contract or identification number238710
Number of Individuals Covered199
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $5,172
Total amount of fees paid to insurance companyUSD $2,465
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $43,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,172
Amount paid for insurance broker fees2465
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTH RISK PARTNERS, LLC
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 2
Insurance contract or identification numberC09162
Number of Individuals Covered245
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $34,665
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEAP
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 CarrierUSD $1,357,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,565
Insurance broker organization code?3
Insurance broker nameFRED DANIEL & SONS, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010106549
Policy instance 3
Insurance contract or identification number000010106549
Number of Individuals Covered228
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $3,924
Total amount of fees paid to insurance companyUSD $798
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $32,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees798
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $3,924
Insurance broker namePATRICK J MCCANN
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 1
Insurance contract or identification numberC09162
Number of Individuals Covered245
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $27,938
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $1,141,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,938
Insurance broker organization code?3
Insurance broker nameJIM RULEY & CO. INC.
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 2
Insurance contract or identification number4121
Number of Individuals Covered141
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $4,858
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,858
Insurance broker organization code?3
Insurance broker nameJIM RULEY & CO INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010106549
Policy instance 1
Insurance contract or identification number000010106549
Number of Individuals Covered199
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $3,475
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $28,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,475
Insurance broker organization code?3
Insurance broker namePATRICK J MCCANN
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 2
Insurance contract or identification numberC09162
Number of Individuals Covered195
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $26,118
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $947,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,059
Insurance broker organization code?3
Insurance broker nameFRED DANIEL & SONS, INC.
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 3
Insurance contract or identification number4121
Number of Individuals Covered119
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $4,640
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,640
Insurance broker organization code?3
Insurance broker nameJIM RULEY & CO INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010106549
Policy instance 3
Insurance contract or identification number000010106549
Number of Individuals Covered174
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $3,149
Total amount of fees paid to insurance companyUSD $987
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $26,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number4121
Policy instance 2
Insurance contract or identification number4121
Number of Individuals Covered109
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $3,688
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09162
Policy instance 1
Insurance contract or identification numberC09162
Number of Individuals Covered190
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $23,706
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $772,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010106549
Policy instance 1
Insurance contract or identification number000010106549
Number of Individuals Covered142
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $2,104
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $17,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,104
Insurance broker organization code?3
Insurance broker namePATRICK J MCCANN
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract number99097
Policy instance 2
Insurance contract or identification number99097
Number of Individuals Covered166
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $23,729
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $737,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,011
Insurance broker organization code?3
Insurance broker nameFRED DANIEL & SONS, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010106549
Policy instance 2
Insurance contract or identification number000010106549
Number of Individuals Covered147
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $2,446
Total amount of fees paid to insurance companyUSD $893
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $20,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees893
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $2,446
Insurance broker namePATRICK J MCCANN
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract number99097
Policy instance 1
Insurance contract or identification number99097
Number of Individuals Covered183
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $27,077
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $774,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,503
Insurance broker organization code?3
Insurance broker nameFRED DANIEL & SONS, INC.
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract number99097
Policy instance 2
Insurance contract or identification number99097
Number of Individuals Covered183
Insurance policy start date2008-09-01
Insurance policy end date2009-08-31
Total amount of commissions paid to insurance brokerUSD $23,271
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $684,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,635
Insurance broker organization code?3
Insurance broker nameFRED DANIEL & SONS, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010106549
Policy instance 1
Insurance contract or identification number000010106549
Number of Individuals Covered156
Insurance policy start date2008-09-01
Insurance policy end date2009-08-31
Total amount of fees paid to insurance companyUSD $2,797
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 CarrierUSD $20,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees350
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $2,447
Insurance broker namePATRICK J MCCANN

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