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YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 401k Plan overview

Plan NameYWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN
Plan identification number 501

YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

YOUNG WOMEN CHRISTIAN ASSOCIATION EL PASO DEL NORTE has sponsored the creation of one or more 401k plans.

Company Name:YOUNG WOMEN CHRISTIAN ASSOCIATION EL PASO DEL NORTE
Employer identification number (EIN):741109650
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01SYLVIA ACOSTA SYLVIA ACOSTA2018-08-30
5012016-01-01SYLVIA ACOSTA SYLVIA ACOSTA2017-09-27
5012015-01-01ELKE CUMMING ELKE CUMMING2016-09-07
5012014-01-01SANDRA BRAHAM SANDRA BRAHAM2015-09-17
5012013-01-01SANDRA BRAHAM SANDRA BRAHAM2014-10-07
5012012-01-01SANDRA BRAHAM SANDRA BRAHAM2013-10-07
5012011-01-01SANDRA BRAHAM SANDRA BRAHAM2012-09-26
5012009-01-01SANDRA BRAHAM SANDRA BRAHAM2010-09-28

Plan Statistics for YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN

401k plan membership statisitcs for YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN

Measure Date Value
2022: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01237
Total number of active participants reported on line 7a of the Form 55002022-01-01264
Total of all active and inactive participants2022-01-01264
Total participants2022-01-01264
2021: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01270
Total number of active participants reported on line 7a of the Form 55002021-01-01237
Total of all active and inactive participants2021-01-01237
Total participants2021-01-01237
2020: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01249
Total number of active participants reported on line 7a of the Form 55002020-01-01270
Total of all active and inactive participants2020-01-01270
Total participants2020-01-01270
2019: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01249
Total number of active participants reported on line 7a of the Form 55002019-01-01230
Total of all active and inactive participants2019-01-01230
Total participants2019-01-01230
2018: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01249
Total number of active participants reported on line 7a of the Form 55002018-01-01195
Total of all active and inactive participants2018-01-01195
Total participants2018-01-01195
2017: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01229
Total number of active participants reported on line 7a of the Form 55002017-01-01249
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01249
2016: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01225
Total number of active participants reported on line 7a of the Form 55002016-01-01229
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01229
2015: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01261
Total number of active participants reported on line 7a of the Form 55002015-01-01225
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01225
2014: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01246
Total number of active participants reported on line 7a of the Form 55002014-01-01261
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01261
2013: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01239
Total number of active participants reported on line 7a of the Form 55002013-01-01246
Total of all active and inactive participants2013-01-01246
2012: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01245
Total number of active participants reported on line 7a of the Form 55002012-01-01239
Total of all active and inactive participants2012-01-01239
2011: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01307
Total number of active participants reported on line 7a of the Form 55002011-01-01245
Total of all active and inactive participants2011-01-01245
2009: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01303
Total number of active participants reported on line 7a of the Form 55002009-01-01303
Total of all active and inactive participants2009-01-01303

Financial Data on YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN

Measure Date Value
2022 : YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2022 401k financial data
Value of total assets at end of year2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31No
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
2020 : YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2020 401k financial data
Value of total assets at end of year2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31No
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
2019 : YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2019 401k financial data
Value of total assets at end of year2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No

Form 5500 Responses for YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN

2022: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: YWCA EL PASO DEL NORTE REGION LIFE INSURANCE AND SHORT-TERM DISABILITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

WORKERS ASSISTANCE PROGRAM (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number
Policy instance 4
Number of Individuals Covered391
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Other welfare benefits providedWORKLIFE/WELLNESS/COUNSELING SVC
Welfare Benefit Premiums Paid to CarrierUSD $5,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05957800
Policy instance 3
Insurance contract or identification numberKM05957800
Number of Individuals Covered264
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $909
Total amount of fees paid to insurance companyUSD $102
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $909
Amount paid for insurance broker fees57
Additional information about fees paid to insurance brokerNONMONETARY COMPENSATION
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number19413
Policy instance 2
Insurance contract or identification number19413
Number of Individuals Covered75
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of fees paid to insurance companyUSD $792
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $367,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees792
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE5030317
Policy instance 1
Insurance contract or identification numberE5030317
Number of Individuals Covered110
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $11,960
Total amount of fees paid to insurance companyUSD $1,710
Other welfare benefits providedCRITICAL ILLNESS INSURANCE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,194
Amount paid for insurance broker fees497
Additional information about fees paid to insurance brokerBONUSES AND NONCASH INCENTIVES
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE5030317
Policy instance 1
Insurance contract or identification numberE5030317
Number of Individuals Covered106
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $11,869
Total amount of fees paid to insurance companyUSD $2,318
Other welfare benefits providedCRITICAL ILLNESS INSURANCE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,379
Amount paid for insurance broker fees160
Additional information about fees paid to insurance brokerBONUSES AND NONCASH INCENTIVES
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number19413
Policy instance 2
Insurance contract or identification number19413
Number of Individuals Covered67
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $14,936
Total amount of fees paid to insurance companyUSD $3,559
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $334,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,936
Amount paid for insurance broker fees840
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05957800
Policy instance 3
Insurance contract or identification numberKM05957800
Number of Individuals Covered237
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $3,788
Total amount of fees paid to insurance companyUSD $505
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,532
Amount paid for insurance broker fees21
Additional information about fees paid to insurance brokerNONMONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5957800
Policy instance 4
Insurance contract or identification number5957800
Number of Individuals Covered272
Insurance policy start date2020-02-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $1,224
Total amount of fees paid to insurance companyUSD $1,344
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $13,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1344
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,224
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05957800
Policy instance 3
Insurance contract or identification numberKM05957800
Number of Individuals Covered270
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $3,762
Total amount of fees paid to insurance companyUSD $54
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $44,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,762
Amount paid for insurance broker fees54
Additional information about fees paid to insurance brokerNONMONETARY COMPENSATION
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number19413
Policy instance 2
Insurance contract or identification number19413
Number of Individuals Covered86
Total amount of commissions paid to insurance brokerUSD $21,070
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $381,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,070
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE5030317
Policy instance 1
Insurance contract or identification numberE5030317
Number of Individuals Covered148
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $14,663
Total amount of fees paid to insurance companyUSD $5,125
Other welfare benefits providedCRITICAL ILLNESS INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $59,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,003
Amount paid for insurance broker fees227
Additional information about fees paid to insurance brokerBONUSES
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number19413
Policy instance 3
Insurance contract or identification number19413
Number of Individuals Covered84
Total amount of commissions paid to insurance brokerUSD $19,432
Total amount of fees paid to insurance companyUSD $1,795
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $430,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,432
Amount paid for insurance broker fees1795
Additional information about fees paid to insurance brokerBONUSES
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE5030317
Policy instance 2
Insurance contract or identification numberE5030317
Number of Individuals Covered139
Total amount of commissions paid to insurance brokerUSD $15,980
Total amount of fees paid to insurance companyUSD $8,316
Other welfare benefits providedCRITICAL ILLNESS INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $57,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,635
Amount paid for insurance broker fees1296
Additional information about fees paid to insurance brokerBONUSES AND NONCASH INCENTIVES
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ00635
Policy instance 1
Insurance contract or identification numberGFZ00635
Number of Individuals Covered91
Insurance policy start date2019-01-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $85
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $85
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ00635
Policy instance 1
Insurance contract or identification numberGFZ00635
Number of Individuals Covered229
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,128
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEPSUPS, DEPSUPC
Welfare Benefit Premiums Paid to CarrierUSD $17,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,128
Insurance broker organization code?3
Insurance broker nameJOHN D WILLIAMS COMPANY DBA JDW INS
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ00635
Policy instance 1
Insurance contract or identification numberGFZ00635
Number of Individuals Covered225
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,229
Total amount of fees paid to insurance companyUSD $858
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEPSUPS, DEPSUPC
Welfare Benefit Premiums Paid to CarrierUSD $18,252
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,229
Amount paid for insurance broker fees858
Additional information about fees paid to insurance brokerOTHER FEES
Insurance broker organization code?3
Insurance broker nameJOHN D WILLIAMS COMANY DBA JDW INS
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ00635
Policy instance 1
Insurance contract or identification numberGFZ00635
Number of Individuals Covered261
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,011
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEPSUPS, DEPSUPC
Welfare Benefit Premiums Paid to CarrierUSD $17,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,011
Insurance broker organization code?3
Insurance broker nameJOHN D WILLIAMS COMANY DBA JDW INS
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ00635
Policy instance 1
Insurance contract or identification numberGFZ00635
Number of Individuals Covered246
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,045
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEPSUPS, DEPSUPC
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,045
Insurance broker organization code?3
Insurance broker nameJOHN D WILLIAMS COMANY DBA JDW INS
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ00635
Policy instance 1
Insurance contract or identification numberGFZ00635
Number of Individuals Covered239
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,966
Total amount of fees paid to insurance companyUSD $55
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEPSUPS, DEPSUPC
Welfare Benefit Premiums Paid to CarrierUSD $16,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,966
Amount paid for insurance broker fees55
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameJOHN D WILLIAMS CO DBA JDW INS
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ00635
Policy instance 1
Insurance contract or identification numberGFZ00635
Number of Individuals Covered245
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,468
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,277
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ00635
Policy instance 1
Insurance contract or identification numberGFZ00635
Number of Individuals Covered307
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,593
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,772
Insurance broker organization code?3
Insurance broker nameELIZABETH RIOS-CARL

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