SCOTT ELECTRIC COMPANY, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN
401k plan membership statisitcs for SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN
| Measure | Date | Value |
|---|
| 2021: SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-12-01 | 94 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 84 |
| Total of all active and inactive participants | 2021-12-01 | 84 |
| 2020: SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-12-01 | 191 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 94 |
| Total of all active and inactive participants | 2020-12-01 | 94 |
| 2019: SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-12-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 191 |
| Total of all active and inactive participants | 2019-12-01 | 191 |
| 2018: SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-12-01 | 214 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 200 |
| Total of all active and inactive participants | 2018-12-01 | 200 |
| 2017: SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-12-01 | 232 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 214 |
| Total of all active and inactive participants | 2017-12-01 | 214 |
| 2016: SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-12-01 | 240 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 232 |
| Total of all active and inactive participants | 2016-12-01 | 232 |
| 2015: SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-12-01 | 269 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 240 |
| Total of all active and inactive participants | 2015-12-01 | 240 |
| 2014: SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-12-01 | 186 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-12-01 | 269 |
| Total of all active and inactive participants | 2014-12-01 | 269 |
| 2011: SCOTT ELECTRIC COMPANY, INC. WELFARE BENEFT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-12-01 | 93 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-12-01 | 152 |
| Total of all active and inactive participants | 2011-12-01 | 152 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010210449 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010210449 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2022-11-30 | | Total amount of commissions paid to insurance broker | USD $3,031 | | Total amount of fees paid to insurance company | USD $1,010 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,207 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,031 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1010 | | Additional information about fees paid to insurance broker | OVERRIDES |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400210448 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400210448 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2022-11-30 | | Total amount of commissions paid to insurance broker | USD $3,141 | | Total amount of fees paid to insurance company | USD $1,047 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,940 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,141 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1047 | | Additional information about fees paid to insurance broker | OVERRIDES |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 807378 |
| Policy instance | 2 |
| Insurance contract or identification number | 807378 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2022-11-30 | | Total amount of commissions paid to insurance broker | USD $7,725 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $60,214 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,943 | | Insurance broker organization code? | 3 |
|
| HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 ) |
| Policy contract number | 807378 |
| Policy instance | 1 |
| Insurance contract or identification number | 807378 | | Number of Individuals Covered | 84 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2022-11-30 | | Total amount of commissions paid to insurance broker | USD $46,051 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $940,282 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,051 | | Insurance broker organization code? | 3 |
|
| HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 ) |
| Policy contract number | 807378 |
| Policy instance | 1 |
| Insurance contract or identification number | 807378 | | Number of Individuals Covered | 94 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Total amount of commissions paid to insurance broker | USD $45,959 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $919,174 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,959 | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 807378 |
| Policy instance | 2 |
| Insurance contract or identification number | 807378 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Total amount of commissions paid to insurance broker | USD $7,202 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,407 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,540 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400210448 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400210448 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-30 | | Total amount of commissions paid to insurance broker | USD $3,217 | | Total amount of fees paid to insurance company | USD $1,073 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,450 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,217 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1073 | | Additional information about fees paid to insurance broker | OVERRIDES |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010210449 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010210449 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-30 | | Total amount of commissions paid to insurance broker | USD $3,206 | | Total amount of fees paid to insurance company | USD $1,069 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,206 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1069 | | Additional information about fees paid to insurance broker | OVERRIDES |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010210449 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010210449 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Total amount of commissions paid to insurance broker | USD $3,588 | | Total amount of fees paid to insurance company | USD $1,300 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,918 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,588 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1196 | | Additional information about fees paid to insurance broker | OVERRIDES |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400210448 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400210448 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Total amount of commissions paid to insurance broker | USD $3,253 | | Total amount of fees paid to insurance company | USD $1,182 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,687 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1084 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $3,253 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 807378 |
| Policy instance | 2 |
| Insurance contract or identification number | 807378 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Total amount of commissions paid to insurance broker | USD $9,779 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $60,804 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,540 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 091914 |
| Policy instance | 1 |
| Insurance contract or identification number | 091914 | | Number of Individuals Covered | 191 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Total amount of commissions paid to insurance broker | USD $28,495 | | Total amount of fees paid to insurance company | USD $1,272 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,113,014 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,495 | | Amount paid for insurance broker fees | 1272 | | Additional information about fees paid to insurance broker | BONUSES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400210448 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400210448 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Total amount of commissions paid to insurance broker | USD $2,879 | | Total amount of fees paid to insurance company | USD $1,621 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,195 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,879 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 960 | | Additional information about fees paid to insurance broker | OVERRIDES |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010210449 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010210449 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Total amount of commissions paid to insurance broker | USD $3,052 | | Total amount of fees paid to insurance company | USD $1,731 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,346 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,052 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1017 | | Additional information about fees paid to insurance broker | OVERRIDES |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 807378 |
| Policy instance | 2 |
| Insurance contract or identification number | 807378 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Total amount of commissions paid to insurance broker | USD $6,173 | | Total amount of fees paid to insurance company | USD $2,000 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $61,912 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,745 | | Amount paid for insurance broker fees | 1000 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 091914 |
| Policy instance | 1 |
| Insurance contract or identification number | 091914 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Total amount of commissions paid to insurance broker | USD $27,349 | | Total amount of fees paid to insurance company | USD $1,416 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $919,209 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,349 | | Amount paid for insurance broker fees | 1416 | | Additional information about fees paid to insurance broker | BONUSES | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 091914 |
| Policy instance | 1 |
| Insurance contract or identification number | 091914 | | Number of Individuals Covered | 214 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $31,574 | | Total amount of fees paid to insurance company | USD $1,089 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $984,406 | | 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 number | 1D031354 |
| Policy instance | 2 |
| Insurance contract or identification number | 1D031354 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $6,436 | | Total amount of fees paid to insurance company | USD $186 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,506 | | 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 number | 000400210448 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400210448 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $3,797 | | Total amount of fees paid to insurance company | USD $125 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,986 | | 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 number | 000010210449 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010210449 | | Number of Individuals Covered | 35 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $3,096 | | Total amount of fees paid to insurance company | USD $1,171 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,639 | | 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 number | 1D031354 |
| Policy instance | 2 |
| Insurance contract or identification number | 1D031354 | | Number of Individuals Covered | 99 | | Insurance policy start date | 2015-12-01 | | Insurance policy end date | 2016-11-30 | | Total amount of commissions paid to insurance broker | USD $8,425 | | Total amount of fees paid to insurance company | USD $2,000 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,810 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,481 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2000 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker name | USB HEALTH LLC |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 091914 |
| Policy instance | 1 |
| Insurance contract or identification number | 091914 | | Number of Individuals Covered | 240 | | Insurance policy start date | 2015-12-01 | | Insurance policy end date | 2016-11-30 | | Total amount of commissions paid to insurance broker | USD $34,944 | | Total amount of fees paid to insurance company | USD $1,344 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,207,951 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,944 | | Amount paid for insurance broker fees | 1344 | | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS FEES PAID TO BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN A. LUDDEKE |
|
| HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 ) |
| Policy contract number | 633351 |
| Policy instance | 2 |
| Insurance contract or identification number | 633351 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $6,433 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,018 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,361 | | Insurance broker name | USB HEALTH LLC |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 091914 |
| Policy instance | 1 |
| Insurance contract or identification number | 091914 | | Number of Individuals Covered | 269 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $29,806 | | Total amount of fees paid to insurance company | USD $990 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,032,042 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,806 | | Amount paid for insurance broker fees | 990 | | Additional information about fees paid to insurance broker | OTHER COMMISSIONS PAID ON CONTRACT | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN A. LUDDEKE |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 091914 |
| Policy instance | 1 |
| Insurance contract or identification number | 091914 | | Number of Individuals Covered | 152 | | Insurance policy start date | 2011-12-01 | | Insurance policy end date | 2012-11-30 | | Total amount of commissions paid to insurance broker | USD $16,313 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $544,976 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | 07530 |
| Policy instance | 1 |
| Insurance contract or identification number | 07530 | | Number of Individuals Covered | 135 | | Insurance policy start date | 2010-12-01 | | Insurance policy end date | 2011-11-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $266,085 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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