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NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 401k Plan overview

Plan NameNAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN
Plan identification number 501

NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN Benefits

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

401k Sponsoring company profile

RALLY CREDIT UNION has sponsored the creation of one or more 401k plans.

Company Name:RALLY CREDIT UNION
Employer identification number (EIN):741237070
NAIC Classification:522130
NAIC Description:Credit Unions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-11-01VIRGINIA WHITHAM2023-04-07
5012020-11-01VIRGINIA WHITHAM2022-07-26
5012019-11-01VIRGINIA WHITHAM2021-06-24
5012018-11-01VIRGINIA WHITHAM2020-05-22
5012017-11-01VIRGINIA WHITHAM2019-06-14
5012016-11-01
5012015-11-01VIRGINIA WHITHAM
5012014-11-01SARAH OBRIEN
5012013-11-01SARAH O'BRIEN
5012012-11-01SARAH OBRIEN
5012011-11-01SARAH O'BRIEN
5012010-11-01SARAH O'BRIEN
5012009-11-01SARAH O'BRIEN
5012008-11-01
5012008-11-01

Plan Statistics for NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN

401k plan membership statisitcs for NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN

Measure Date Value
2021: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-11-01580
Total number of active participants reported on line 7a of the Form 55002021-11-01602
Number of retired or separated participants receiving benefits2021-11-010
Number of other retired or separated participants entitled to future benefits2021-11-010
Total of all active and inactive participants2021-11-01602
Number of employers contributing to the scheme2021-11-010
2020: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-11-01556
Total number of active participants reported on line 7a of the Form 55002020-11-01580
Number of retired or separated participants receiving benefits2020-11-010
Number of other retired or separated participants entitled to future benefits2020-11-010
Total of all active and inactive participants2020-11-01580
Number of employers contributing to the scheme2020-11-010
2019: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-01525
Total number of active participants reported on line 7a of the Form 55002019-11-01556
Number of retired or separated participants receiving benefits2019-11-010
Number of other retired or separated participants entitled to future benefits2019-11-010
Total of all active and inactive participants2019-11-01556
Number of employers contributing to the scheme2019-11-010
2018: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-11-01491
Total number of active participants reported on line 7a of the Form 55002018-11-01527
Number of retired or separated participants receiving benefits2018-11-010
Number of other retired or separated participants entitled to future benefits2018-11-010
Total of all active and inactive participants2018-11-01527
Number of employers contributing to the scheme2018-11-010
2017: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-11-01491
Total number of active participants reported on line 7a of the Form 55002017-11-01619
Number of retired or separated participants receiving benefits2017-11-010
Number of other retired or separated participants entitled to future benefits2017-11-010
Total of all active and inactive participants2017-11-01619
Number of employers contributing to the scheme2017-11-010
2016: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-01393
Total number of active participants reported on line 7a of the Form 55002016-11-01403
Number of retired or separated participants receiving benefits2016-11-010
Number of other retired or separated participants entitled to future benefits2016-11-010
Total of all active and inactive participants2016-11-01403
2015: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-11-01359
Total number of active participants reported on line 7a of the Form 55002015-11-01391
Number of retired or separated participants receiving benefits2015-11-010
Number of other retired or separated participants entitled to future benefits2015-11-010
Total of all active and inactive participants2015-11-01391
2014: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-01304
Total number of active participants reported on line 7a of the Form 55002014-11-01359
Number of retired or separated participants receiving benefits2014-11-010
Number of other retired or separated participants entitled to future benefits2014-11-010
Total of all active and inactive participants2014-11-01359
2013: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-01267
Total number of active participants reported on line 7a of the Form 55002013-11-01304
Number of retired or separated participants receiving benefits2013-11-010
Number of other retired or separated participants entitled to future benefits2013-11-010
Total of all active and inactive participants2013-11-01304
2012: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-01250
Total number of active participants reported on line 7a of the Form 55002012-11-01267
Number of retired or separated participants receiving benefits2012-11-010
Number of other retired or separated participants entitled to future benefits2012-11-010
Total of all active and inactive participants2012-11-01267
2011: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-01204
Total number of active participants reported on line 7a of the Form 55002011-11-01237
Total of all active and inactive participants2011-11-01237
Total participants2011-11-01237
2010: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-11-01190
Total number of active participants reported on line 7a of the Form 55002010-11-01204
Total of all active and inactive participants2010-11-01204
Total participants2010-11-01204
2009: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-11-01179
Total number of active participants reported on line 7a of the Form 55002009-11-01190
Total of all active and inactive participants2009-11-01190
Total participants2009-11-01190

Financial Data on NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN

Measure Date Value
2012 : NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2012 401k financial data
Total transfer of assets from this plan2012-10-31$943,179
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-10-31$45,423
Total income from all sources (including contributions)2012-10-31$1,658,032
Total of all expenses incurred2012-10-31$1,499,284
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-10-31$1,352,054
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-10-31$1,658,032
Value of total assets at beginning of year2012-10-31$829,854
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-10-31$147,230
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-10-31No
Was this plan covered by a fidelity bond2012-10-31No
Were there any nonexempt tranactions with any party-in-interest2012-10-31No
Contributions received from participants2012-10-31$180,325
Participant contributions at beginning of year2012-10-31$14,873
Income. Received or receivable in cash from other sources (including rollovers)2012-10-31$45,423
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-10-31$3,190
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-10-31$45,423
Administrative expenses (other) incurred2012-10-31$147,230
Total non interest bearing cash at beginning of year2012-10-31$698,500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-10-31No
Value of net income/loss2012-10-31$158,748
Value of net assets at beginning of year (total assets less liabilities)2012-10-31$784,431
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-10-31No
Were any leases to which the plan was party in default or uncollectible2012-10-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-10-31$309,919
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-10-31No
Was there a failure to transmit to the plan any participant contributions2012-10-31No
Has the plan failed to provide any benefit when due under the plan2012-10-31No
Contributions received in cash from employer2012-10-31$1,432,284
Employer contributions (assets) at beginning of year2012-10-31$113,291
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-10-31$1,042,135
Did the plan have assets held for investment2012-10-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-10-31No
Opinion of an independent qualified public accountant for this plan2012-10-31Unqualified
Accountancy firm name2012-10-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2012-10-31410746749
2011 : NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-10-31$45,423
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-10-31$230,036
Total income from all sources (including contributions)2011-10-31$1,642,489
Total of all expenses incurred2011-10-31$1,075,958
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-10-31$944,061
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-10-31$1,642,489
Value of total assets at end of year2011-10-31$829,854
Value of total assets at beginning of year2011-10-31$447,936
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-10-31$131,897
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-10-31No
Was this plan covered by a fidelity bond2011-10-31No
Were there any nonexempt tranactions with any party-in-interest2011-10-31No
Contributions received from participants2011-10-31$176,815
Participant contributions at end of year2011-10-31$14,873
Participant contributions at beginning of year2011-10-31$12,541
Income. Received or receivable in cash from other sources (including rollovers)2011-10-31$157,080
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-10-31$3,190
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-10-31$2,292
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-10-31$45,423
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-10-31$202,503
Administrative expenses (other) incurred2011-10-31$131,897
Liabilities. Value of operating payables at beginning of year2011-10-31$27,533
Total non interest bearing cash at end of year2011-10-31$698,500
Total non interest bearing cash at beginning of year2011-10-31$339,052
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-10-31No
Value of net income/loss2011-10-31$566,531
Value of net assets at end of year (total assets less liabilities)2011-10-31$784,431
Value of net assets at beginning of year (total assets less liabilities)2011-10-31$217,900
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-10-31No
Were any leases to which the plan was party in default or uncollectible2011-10-31No
Expenses. Payments to insurance carriers foe the provision of benefits2011-10-31$292,871
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-10-31No
Was there a failure to transmit to the plan any participant contributions2011-10-31No
Has the plan failed to provide any benefit when due under the plan2011-10-31No
Contributions received in cash from employer2011-10-31$1,308,594
Employer contributions (assets) at end of year2011-10-31$113,291
Employer contributions (assets) at beginning of year2011-10-31$94,051
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-10-31$651,190
Did the plan have assets held for investment2011-10-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-10-31No
Opinion of an independent qualified public accountant for this plan2011-10-31Unqualified
Accountancy firm name2011-10-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2011-10-31410746749

Form 5500 Responses for NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN

2021: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2021 form 5500 responses
2021-11-01Type of plan entitySingle employer plan
2021-11-01Plan funding arrangement – InsuranceYes
2021-11-01Plan funding arrangement – General assets of the sponsorYes
2021-11-01Plan benefit arrangement – InsuranceYes
2021-11-01Plan benefit arrangement – General assets of the sponsorYes
2020: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2020 form 5500 responses
2020-11-01Type of plan entitySingle employer plan
2020-11-01Plan funding arrangement – InsuranceYes
2020-11-01Plan funding arrangement – General assets of the sponsorYes
2020-11-01Plan benefit arrangement – InsuranceYes
2020-11-01Plan benefit arrangement – General assets of the sponsorYes
2019: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan funding arrangement – General assets of the sponsorYes
2019-11-01Plan benefit arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – General assets of the sponsorYes
2018: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan funding arrangement – General assets of the sponsorYes
2018-11-01Plan benefit arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – General assets of the sponsorYes
2017: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan funding arrangement – General assets of the sponsorYes
2017-11-01Plan benefit arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – General assets of the sponsorYes
2016: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan funding arrangement – General assets of the sponsorYes
2016-11-01Plan benefit arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – General assets of the sponsorYes
2015: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingNo
2015-11-01This return/report is a short plan year return/report (less than 12 months)No
2015-11-01Plan is a collectively bargained planNo
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan funding arrangement – General assets of the sponsorYes
2015-11-01Plan benefit arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – General assets of the sponsorYes
2014: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01Submission has been amendedNo
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planNo
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan funding arrangement – General assets of the sponsorYes
2014-11-01Plan benefit arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – General assets of the sponsorYes
2013: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Submission has been amendedNo
2013-11-01This submission is the final filingNo
2013-11-01This return/report is a short plan year return/report (less than 12 months)No
2013-11-01Plan is a collectively bargained planNo
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan funding arrangement – General assets of the sponsorYes
2013-11-01Plan benefit arrangement – InsuranceYes
2013-11-01Plan benefit arrangement – General assets of the sponsorYes
2012: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan funding arrangement – General assets of the sponsorYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – General assets of the sponsorYes
2011: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan funding arrangement – TrustYes
2011-11-01Plan benefit arrangement – InsuranceYes
2011-11-01Plan benefit arrangement - TrustYes
2010: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2010 form 5500 responses
2010-11-01Type of plan entitySingle employer plan
2010-11-01Plan funding arrangement – InsuranceYes
2010-11-01Plan funding arrangement – TrustYes
2010-11-01Plan benefit arrangement – InsuranceYes
2010-11-01Plan benefit arrangement - TrustYes
2009: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan funding arrangement – TrustYes
2009-11-01Plan benefit arrangement – InsuranceYes
2009-11-01Plan benefit arrangement - TrustYes
2008: NAVY ARMY FEDERAL CREDIT UNION HEALTH PLAN 2008 form 5500 responses
2008-11-01Type of plan entitySingle employer plan
2008-11-01Submission has been amendedNo
2008-11-01This submission is the final filingNo
2008-11-01This return/report is a short plan year return/report (less than 12 months)No
2008-11-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number8801638
Policy instance 6
Insurance contract or identification number8801638
Number of Individuals Covered602
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40320
Policy instance 5
Insurance contract or identification numberHCCLOT40320
Number of Individuals Covered622
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $10,277
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $75,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees7557
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number53891
Policy instance 4
Insurance contract or identification number53891
Number of Individuals Covered120
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $25,846
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, CANCER, HEART/STROKE
Welfare Benefit Premiums Paid to CarrierUSD $151,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,608
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number948178
Policy instance 3
Insurance contract or identification number948178
Number of Individuals Covered602
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $57,184
Total amount of fees paid to insurance companyUSD $20,608
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $415,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,184
Amount paid for insurance broker fees20608
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number325970
Policy instance 2
Insurance contract or identification number325970
Number of Individuals Covered627
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $6,085
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,085
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5912341
Policy instance 1
Insurance contract or identification number5912341
Number of Individuals Covered995
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $31,041
Total amount of fees paid to insurance companyUSD $5,536
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $322,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,041
Amount paid for insurance broker fees54
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5912341
Policy instance 1
Insurance contract or identification number5912341
Number of Individuals Covered919
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $37,689
Total amount of fees paid to insurance companyUSD $5,655
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $315,339
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,689
Amount paid for insurance broker fees41
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number325970
Policy instance 2
Insurance contract or identification number325970
Number of Individuals Covered573
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $5,161
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,161
Amount paid for insurance broker fees0
Insurance broker organization code?3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number53891
Policy instance 3
Insurance contract or identification number53891
Number of Individuals Covered106
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $14,997
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, CANCER, HEART/STROKE
Welfare Benefit Premiums Paid to CarrierUSD $130,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,070
Amount paid for insurance broker fees0
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40320
Policy instance 4
Insurance contract or identification numberHCCLOT40320
Number of Individuals Covered566
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $6,634
Total amount of fees paid to insurance companyUSD $2,388
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $6,634
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,317
Amount paid for insurance broker fees1194
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number00
Policy instance 5
Insurance contract or identification number00
Number of Individuals Covered580
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BFKN
Policy instance 6
Insurance contract or identification numberGLUG0BFKN
Number of Individuals Covered580
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $46,928
Total amount of fees paid to insurance companyUSD $16,615
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $296,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,928
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BFKN
Policy instance 6
Insurance contract or identification numberGLUG0BFKN
Number of Individuals Covered560
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $43,185
Total amount of fees paid to insurance companyUSD $15,565
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $272,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,185
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number00
Policy instance 5
Insurance contract or identification number00
Number of Individuals Covered542
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $7,138
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,138
Amount paid for insurance broker fees0
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40320
Policy instance 4
Insurance contract or identification numberHCCLOT40320
Number of Individuals Covered548
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $6,175
Total amount of fees paid to insurance companyUSD $2,223
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $61,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,175
Amount paid for insurance broker fees2223
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number53891
Policy instance 3
Insurance contract or identification number53891
Number of Individuals Covered113
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $27,427
Total amount of fees paid to insurance companyUSD $98
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, CANCER, HEART/STROKE
Welfare Benefit Premiums Paid to CarrierUSD $150,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,602
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number325970
Policy instance 2
Insurance contract or identification number325970
Number of Individuals Covered564
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $5,115
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,115
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5912341
Policy instance 1
Insurance contract or identification number5912341
Number of Individuals Covered898
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $22,978
Total amount of fees paid to insurance companyUSD $3,638
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $283,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3543
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5912341
Policy instance 1
Insurance contract or identification number5912341
Number of Individuals Covered805
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $25,660
Total amount of fees paid to insurance companyUSD $3,317
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $279,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,660
Amount paid for insurance broker fees75
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number325970
Policy instance 2
Insurance contract or identification number325970
Number of Individuals Covered520
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $4,838
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,838
Amount paid for insurance broker fees0
Insurance broker organization code?3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number53891
Policy instance 3
Insurance contract or identification number53891
Number of Individuals Covered102
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $25,385
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, CANCER, HEART/STROKE
Welfare Benefit Premiums Paid to CarrierUSD $154,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,161
Amount paid for insurance broker fees0
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40285
Policy instance 4
Insurance contract or identification numberHCCLOT40285
Number of Individuals Covered525
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $5,923
Total amount of fees paid to insurance companyUSD $2,132
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $59,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,923
Amount paid for insurance broker fees2132
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number00
Policy instance 5
Insurance contract or identification number00
Number of Individuals Covered625
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BFKN
Policy instance 6
Insurance contract or identification numberGLUG0BFKN
Number of Individuals Covered513
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $36,938
Total amount of fees paid to insurance companyUSD $10,381
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $237,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,938
Amount paid for insurance broker fees9229
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number00
Policy instance 5
Insurance contract or identification number00
Number of Individuals Covered619
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number53891
Policy instance 4
Insurance contract or identification number53891
Number of Individuals Covered93
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $19,584
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, CANCER, HEART/STROKE
Welfare Benefit Premiums Paid to CarrierUSD $142,467
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number1393
Policy instance 3
Insurance contract or identification number1393
Number of Individuals Covered462
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $33,159
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $216,270
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 number5912341
Policy instance 1
Insurance contract or identification number5912341
Number of Individuals Covered803
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $25,644
Total amount of fees paid to insurance companyUSD $3,439
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $258,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number325970
Policy instance 2
Insurance contract or identification number325970
Number of Individuals Covered483
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $4,831
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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