PARENT/CHILD,INC TSA PLAN has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PARENT/CHILD, INC. TSA PLAN
401k plan membership statisitcs for PARENT/CHILD, INC. TSA PLAN
Measure | Date | Value |
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2022 : PARENT/CHILD, INC. TSA PLAN 2022 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2022-08-31 | $0 |
Total transfer of assets to this plan | 2022-08-31 | $43,234 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-08-31 | $0 |
Total income from all sources (including contributions) | 2022-08-31 | $457,616 |
Total loss/gain on sale of assets | 2022-08-31 | $0 |
Total of all expenses incurred | 2022-08-31 | $538,222 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-08-31 | $538,222 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-08-31 | $344,552 |
Value of total assets at end of year | 2022-08-31 | $5,588,772 |
Value of total assets at beginning of year | 2022-08-31 | $5,626,144 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-08-31 | $0 |
Total interest from all sources | 2022-08-31 | $113,064 |
Total dividends received (eg from common stock, registered investment company shares) | 2022-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-08-31 | No |
Was this plan covered by a fidelity bond | 2022-08-31 | No |
If this is an individual account plan, was there a blackout period | 2022-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2022-08-31 | No |
Contributions received from participants | 2022-08-31 | $177,602 |
Participant contributions at end of year | 2022-08-31 | $63,860 |
Participant contributions at beginning of year | 2022-08-31 | $84,285 |
Participant contributions at end of year | 2022-08-31 | $16,472 |
Participant contributions at beginning of year | 2022-08-31 | $16,179 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-08-31 | $20,425 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-08-31 | No |
Value of net income/loss | 2022-08-31 | $-80,606 |
Value of net assets at end of year (total assets less liabilities) | 2022-08-31 | $5,588,772 |
Value of net assets at beginning of year (total assets less liabilities) | 2022-08-31 | $5,626,144 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2022-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2022-08-31 | No |
Interest earned on other investments | 2022-08-31 | $-35,132 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-08-31 | $5,493,947 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-08-31 | $5,508,367 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-08-31 | $5,508,367 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-08-31 | $148,196 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2022-08-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2022-08-31 | No |
Contributions received in cash from employer | 2022-08-31 | $166,950 |
Employer contributions (assets) at end of year | 2022-08-31 | $14,493 |
Employer contributions (assets) at beginning of year | 2022-08-31 | $17,313 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-08-31 | $517,797 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-08-31 | No |
Did the plan have assets held for investment | 2022-08-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-08-31 | No |
2021 : PARENT/CHILD, INC. TSA PLAN 2021 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2021-08-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-08-31 | $0 |
Total income from all sources (including contributions) | 2021-08-31 | $460,061 |
Total loss/gain on sale of assets | 2021-08-31 | $0 |
Total of all expenses incurred | 2021-08-31 | $529,690 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-08-31 | $529,690 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-08-31 | $373,156 |
Value of total assets at end of year | 2021-08-31 | $5,626,144 |
Value of total assets at beginning of year | 2021-08-31 | $5,695,773 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-08-31 | $0 |
Total interest from all sources | 2021-08-31 | $86,905 |
Total dividends received (eg from common stock, registered investment company shares) | 2021-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-08-31 | No |
Was this plan covered by a fidelity bond | 2021-08-31 | No |
If this is an individual account plan, was there a blackout period | 2021-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2021-08-31 | No |
Contributions received from participants | 2021-08-31 | $194,081 |
Participant contributions at end of year | 2021-08-31 | $84,285 |
Participant contributions at beginning of year | 2021-08-31 | $87,597 |
Participant contributions at end of year | 2021-08-31 | $16,179 |
Participant contributions at beginning of year | 2021-08-31 | $18,765 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-08-31 | $3,312 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-08-31 | No |
Value of net income/loss | 2021-08-31 | $-69,629 |
Value of net assets at end of year (total assets less liabilities) | 2021-08-31 | $5,626,144 |
Value of net assets at beginning of year (total assets less liabilities) | 2021-08-31 | $5,695,773 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2021-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-08-31 | No |
Interest on participant loans | 2021-08-31 | $0 |
Interest earned on other investments | 2021-08-31 | $-54,943 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-08-31 | $5,508,367 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-08-31 | $5,571,816 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-08-31 | $5,571,816 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-08-31 | $141,848 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2021-08-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2021-08-31 | No |
Contributions received in cash from employer | 2021-08-31 | $179,075 |
Employer contributions (assets) at end of year | 2021-08-31 | $17,313 |
Employer contributions (assets) at beginning of year | 2021-08-31 | $17,595 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-08-31 | $526,378 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-08-31 | No |
Did the plan have assets held for investment | 2021-08-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-08-31 | No |
2020 : PARENT/CHILD, INC. TSA PLAN 2020 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2020-08-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-08-31 | $0 |
Total income from all sources (including contributions) | 2020-08-31 | $410,673 |
Total loss/gain on sale of assets | 2020-08-31 | $0 |
Total of all expenses incurred | 2020-08-31 | $285,287 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-08-31 | $285,287 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-08-31 | $288,797 |
Value of total assets at end of year | 2020-08-31 | $5,695,773 |
Value of total assets at beginning of year | 2020-08-31 | $5,570,387 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-08-31 | $0 |
Total interest from all sources | 2020-08-31 | $121,876 |
Total dividends received (eg from common stock, registered investment company shares) | 2020-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-08-31 | No |
Was this plan covered by a fidelity bond | 2020-08-31 | No |
If this is an individual account plan, was there a blackout period | 2020-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2020-08-31 | No |
Contributions received from participants | 2020-08-31 | $150,032 |
Participant contributions at end of year | 2020-08-31 | $87,597 |
Participant contributions at beginning of year | 2020-08-31 | $114,742 |
Participant contributions at end of year | 2020-08-31 | $18,765 |
Participant contributions at beginning of year | 2020-08-31 | $17,305 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-08-31 | $27,145 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-08-31 | No |
Value of net income/loss | 2020-08-31 | $125,386 |
Value of net assets at end of year (total assets less liabilities) | 2020-08-31 | $5,695,773 |
Value of net assets at beginning of year (total assets less liabilities) | 2020-08-31 | $5,570,387 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-08-31 | No |
Interest earned on other investments | 2020-08-31 | $-49,291 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-08-31 | $5,571,816 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-08-31 | $5,422,367 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-08-31 | $5,422,367 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-08-31 | $171,167 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2020-08-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-08-31 | No |
Contributions received in cash from employer | 2020-08-31 | $138,765 |
Employer contributions (assets) at end of year | 2020-08-31 | $17,595 |
Employer contributions (assets) at beginning of year | 2020-08-31 | $15,973 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-08-31 | $258,142 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-08-31 | No |
Did the plan have assets held for investment | 2020-08-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-08-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-08-31 | No |
Opinion of an independent qualified public accountant for this plan | 2020-08-31 | Disclaimer |
Accountancy firm name | 2020-08-31 | GARZA/GONZALEZ & ASSOCIATES CPAS |
Accountancy firm EIN | 2020-08-31 | 741867466 |
2019 : PARENT/CHILD, INC. TSA PLAN 2019 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2019-08-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-08-31 | $0 |
Total income from all sources (including contributions) | 2019-08-31 | $336,443 |
Total loss/gain on sale of assets | 2019-08-31 | $0 |
Total of all expenses incurred | 2019-08-31 | $546,922 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-08-31 | $546,922 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-08-31 | $277,013 |
Value of total assets at end of year | 2019-08-31 | $5,570,387 |
Value of total assets at beginning of year | 2019-08-31 | $5,780,866 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-08-31 | $0 |
Total interest from all sources | 2019-08-31 | $59,430 |
Total dividends received (eg from common stock, registered investment company shares) | 2019-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-08-31 | No |
Was this plan covered by a fidelity bond | 2019-08-31 | No |
If this is an individual account plan, was there a blackout period | 2019-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2019-08-31 | No |
Contributions received from participants | 2019-08-31 | $144,047 |
Participant contributions at end of year | 2019-08-31 | $114,742 |
Participant contributions at beginning of year | 2019-08-31 | $114,473 |
Participant contributions at end of year | 2019-08-31 | $17,305 |
Participant contributions at beginning of year | 2019-08-31 | $13,888 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-08-31 | $-269 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-08-31 | No |
Value of net income/loss | 2019-08-31 | $-210,479 |
Value of net assets at end of year (total assets less liabilities) | 2019-08-31 | $5,570,387 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-08-31 | $5,780,866 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-08-31 | No |
Interest earned on other investments | 2019-08-31 | $-67,553 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-08-31 | $5,422,367 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-08-31 | $5,639,686 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-08-31 | $5,639,686 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-08-31 | $126,983 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2019-08-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-08-31 | No |
Contributions received in cash from employer | 2019-08-31 | $132,966 |
Employer contributions (assets) at end of year | 2019-08-31 | $15,973 |
Employer contributions (assets) at beginning of year | 2019-08-31 | $12,819 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-08-31 | $547,191 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-08-31 | No |
Did the plan have assets held for investment | 2019-08-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-08-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-08-31 | No |
Opinion of an independent qualified public accountant for this plan | 2019-08-31 | Disclaimer |
Accountancy firm name | 2019-08-31 | GARZA.GONZALEZ & ASSOCIATES CPAS |
Accountancy firm EIN | 2019-08-31 | 741867466 |
2018 : PARENT/CHILD, INC. TSA PLAN 2018 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2018-08-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-08-31 | $0 |
Total income from all sources (including contributions) | 2018-08-31 | $397,557 |
Total loss/gain on sale of assets | 2018-08-31 | $0 |
Total of all expenses incurred | 2018-08-31 | $313,981 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-08-31 | $313,981 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-08-31 | $257,440 |
Value of total assets at end of year | 2018-08-31 | $5,780,866 |
Value of total assets at beginning of year | 2018-08-31 | $5,697,290 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-08-31 | $0 |
Total interest from all sources | 2018-08-31 | $140,117 |
Total dividends received (eg from common stock, registered investment company shares) | 2018-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-08-31 | No |
Was this plan covered by a fidelity bond | 2018-08-31 | No |
If this is an individual account plan, was there a blackout period | 2018-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2018-08-31 | No |
Contributions received from participants | 2018-08-31 | $133,821 |
Participant contributions at end of year | 2018-08-31 | $114,473 |
Participant contributions at beginning of year | 2018-08-31 | $109,151 |
Participant contributions at end of year | 2018-08-31 | $13,888 |
Participant contributions at beginning of year | 2018-08-31 | $12,256 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-08-31 | No |
Value of net income/loss | 2018-08-31 | $83,576 |
Value of net assets at end of year (total assets less liabilities) | 2018-08-31 | $5,780,866 |
Value of net assets at beginning of year (total assets less liabilities) | 2018-08-31 | $5,697,290 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2018-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2018-08-31 | No |
Interest earned on other investments | 2018-08-31 | $-3,965 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-08-31 | $5,639,686 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-08-31 | $5,564,663 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-08-31 | $5,564,663 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-08-31 | $144,082 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2018-08-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2018-08-31 | No |
Contributions received in cash from employer | 2018-08-31 | $123,619 |
Employer contributions (assets) at end of year | 2018-08-31 | $12,819 |
Employer contributions (assets) at beginning of year | 2018-08-31 | $11,220 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-08-31 | $313,981 |
Did the plan have assets held for investment | 2018-08-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-08-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-08-31 | No |
Opinion of an independent qualified public accountant for this plan | 2018-08-31 | Disclaimer |
Accountancy firm name | 2018-08-31 | GARZA/GONZALEZ & ASSOCIATES CPAS |
Accountancy firm EIN | 2018-08-31 | 741867466 |
2017 : PARENT/CHILD, INC. TSA PLAN 2017 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2017-08-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-08-31 | $0 |
Total income from all sources (including contributions) | 2017-08-31 | $343,419 |
Total loss/gain on sale of assets | 2017-08-31 | $0 |
Total of all expenses incurred | 2017-08-31 | $237,329 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-08-31 | $237,329 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-08-31 | $261,779 |
Value of total assets at end of year | 2017-08-31 | $5,669,193 |
Value of total assets at beginning of year | 2017-08-31 | $5,563,103 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-08-31 | $0 |
Total interest from all sources | 2017-08-31 | $81,640 |
Total dividends received (eg from common stock, registered investment company shares) | 2017-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-08-31 | No |
Was this plan covered by a fidelity bond | 2017-08-31 | No |
If this is an individual account plan, was there a blackout period | 2017-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2017-08-31 | No |
Contributions received from participants | 2017-08-31 | $136,125 |
Participant contributions at end of year | 2017-08-31 | $12,256 |
Participant contributions at beginning of year | 2017-08-31 | $5,682 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-08-31 | $109,151 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-08-31 | $115,568 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-08-31 | No |
Value of net income/loss | 2017-08-31 | $106,090 |
Value of net assets at end of year (total assets less liabilities) | 2017-08-31 | $5,669,193 |
Value of net assets at beginning of year (total assets less liabilities) | 2017-08-31 | $5,563,103 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2017-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2017-08-31 | No |
Interest earned on other investments | 2017-08-31 | $-62,164 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-08-31 | $5,536,566 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-08-31 | $5,436,608 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-08-31 | $5,436,608 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-08-31 | $143,804 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2017-08-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2017-08-31 | No |
Contributions received in cash from employer | 2017-08-31 | $125,654 |
Employer contributions (assets) at end of year | 2017-08-31 | $11,220 |
Employer contributions (assets) at beginning of year | 2017-08-31 | $5,245 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-08-31 | $237,329 |
Did the plan have assets held for investment | 2017-08-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-08-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-08-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2017-08-31 | Disclaimer |
Accountancy firm name | 2017-08-31 | GARZA/GONZALEZ & ASSOCIATES CPAS |
Accountancy firm EIN | 2017-08-31 | 741867466 |
2016 : PARENT/CHILD, INC. TSA PLAN 2016 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2016-08-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-08-31 | $0 |
Total income from all sources (including contributions) | 2016-08-31 | $292,638 |
Total loss/gain on sale of assets | 2016-08-31 | $0 |
Total of all expenses incurred | 2016-08-31 | $194,486 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-08-31 | $194,486 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-08-31 | $235,283 |
Value of total assets at end of year | 2016-08-31 | $5,563,103 |
Value of total assets at beginning of year | 2016-08-31 | $5,464,951 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-08-31 | $0 |
Total interest from all sources | 2016-08-31 | $57,355 |
Total dividends received (eg from common stock, registered investment company shares) | 2016-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-08-31 | No |
Was this plan covered by a fidelity bond | 2016-08-31 | No |
If this is an individual account plan, was there a blackout period | 2016-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2016-08-31 | No |
Contributions received from participants | 2016-08-31 | $122,490 |
Participant contributions at end of year | 2016-08-31 | $5,682 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-08-31 | $998 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-08-31 | $115,568 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-08-31 | $158,292 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-08-31 | No |
Value of net income/loss | 2016-08-31 | $98,152 |
Value of net assets at end of year (total assets less liabilities) | 2016-08-31 | $5,563,103 |
Value of net assets at beginning of year (total assets less liabilities) | 2016-08-31 | $5,464,951 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2016-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2016-08-31 | No |
Income. Interest from loans (other than to participants) | 2016-08-31 | $-42,723 |
Interest earned on other investments | 2016-08-31 | $-77,304 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-08-31 | $5,436,608 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-08-31 | $5,306,659 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-08-31 | $5,306,659 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-08-31 | $177,382 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2016-08-31 | Yes |
Has the plan failed to provide any benefit when due under the plan | 2016-08-31 | No |
Contributions received in cash from employer | 2016-08-31 | $112,793 |
Employer contributions (assets) at end of year | 2016-08-31 | $5,245 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-08-31 | $193,488 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-08-31 | No |
Did the plan have assets held for investment | 2016-08-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-08-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-08-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2016-08-31 | Disclaimer |
Accountancy firm name | 2016-08-31 | GARZA/GONZALEZ & ASSOCIATES CPAS |
Accountancy firm EIN | 2016-08-31 | 741867466 |
2013 : PARENT/CHILD, INC. TSA PLAN 2013 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2013-08-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-08-31 | $0 |
Total income from all sources (including contributions) | 2013-08-31 | $0 |
Total loss/gain on sale of assets | 2013-08-31 | $0 |
Total of all expenses incurred | 2013-08-31 | $0 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-08-31 | $0 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-08-31 | $0 |
Value of total assets at end of year | 2013-08-31 | $0 |
Value of total assets at beginning of year | 2013-08-31 | $0 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-08-31 | $0 |
Total interest from all sources | 2013-08-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2013-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-08-31 | No |
Was this plan covered by a fidelity bond | 2013-08-31 | No |
If this is an individual account plan, was there a blackout period | 2013-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2013-08-31 | No |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-08-31 | No |
Value of net income/loss | 2013-08-31 | $0 |
Value of net assets at end of year (total assets less liabilities) | 2013-08-31 | $0 |
Value of net assets at beginning of year (total assets less liabilities) | 2013-08-31 | $0 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2013-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2013-08-31 | No |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2013-08-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2013-08-31 | No |
Did the plan have assets held for investment | 2013-08-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-08-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-08-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2013-08-31 | Disclaimer |
Accountancy firm name | 2013-08-31 | GARZA/GONZALEZ & ASSOCIATES CPAS |
Accountancy firm EIN | 2013-08-31 | 741867466 |
2012 : PARENT/CHILD, INC. TSA PLAN 2012 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2012-08-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-08-31 | $0 |
Total income from all sources (including contributions) | 2012-08-31 | $0 |
Total loss/gain on sale of assets | 2012-08-31 | $0 |
Total of all expenses incurred | 2012-08-31 | $0 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-08-31 | $0 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-08-31 | $0 |
Value of total assets at end of year | 2012-08-31 | $0 |
Value of total assets at beginning of year | 2012-08-31 | $0 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-08-31 | $0 |
Total interest from all sources | 2012-08-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2012-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-08-31 | No |
Was this plan covered by a fidelity bond | 2012-08-31 | No |
If this is an individual account plan, was there a blackout period | 2012-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2012-08-31 | No |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-08-31 | No |
Value of net income/loss | 2012-08-31 | $0 |
Value of net assets at end of year (total assets less liabilities) | 2012-08-31 | $0 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-08-31 | $0 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-08-31 | No |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2012-08-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2012-08-31 | No |
Did the plan have assets held for investment | 2012-08-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-08-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-08-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2012-08-31 | Disclaimer |
Accountancy firm name | 2012-08-31 | GARZA/GONZALEZ & ASSOCIATES CPAS |
Accountancy firm EIN | 2012-08-31 | 741867466 |
2011 : PARENT/CHILD, INC. TSA PLAN 2011 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2011-08-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-08-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-08-31 | $0 |
Total income from all sources (including contributions) | 2011-08-31 | $0 |
Total loss/gain on sale of assets | 2011-08-31 | $0 |
Total of all expenses incurred | 2011-08-31 | $0 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-08-31 | $0 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-08-31 | $0 |
Value of total assets at end of year | 2011-08-31 | $0 |
Value of total assets at beginning of year | 2011-08-31 | $0 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-08-31 | $0 |
Total interest from all sources | 2011-08-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2011-08-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-08-31 | No |
Was this plan covered by a fidelity bond | 2011-08-31 | No |
If this is an individual account plan, was there a blackout period | 2011-08-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2011-08-31 | No |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-08-31 | No |
Value of net income/loss | 2011-08-31 | $0 |
Value of net assets at end of year (total assets less liabilities) | 2011-08-31 | $0 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-08-31 | $0 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-08-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-08-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-08-31 | No |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-08-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2011-08-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2011-08-31 | No |
Did the plan have assets held for investment | 2011-08-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-08-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-08-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-08-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2011-08-31 | Disclaimer |
Accountancy firm name | 2011-08-31 | GARZA/GONZALEZ & ASSOCIATES CPAS |
Accountancy firm EIN | 2011-08-31 | 741867466 |
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 4 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 223 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $984 | Total amount of fees paid to insurance company | USD $1,660 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $6,569 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1350 | Additional information about fees paid to insurance broker | ADMINISTRATION | Insurance broker organization code? | 5 | Commission paid to Insurance Broker | USD $984 |
|
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | EA84 |
Policy instance | 1 |
Insurance contract or identification number | EA84 | Number of Individuals Covered | 1433 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | Total amount of commissions paid to insurance broker | USD $18,328 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | GUARANTEED INTEREST OPTION | Commission paid to Insurance Broker | USD $64 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | RELIASTAR INSURANCE COMMISSION | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 2 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 123 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $1,125 | Total amount of fees paid to insurance company | USD $208 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $11,268 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 208 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 3 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 222 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $2,627 | Total amount of fees paid to insurance company | USD $1,209 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $17,547 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1209 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $2,627 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 5 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 145 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $6,055 | Total amount of fees paid to insurance company | USD $3,712 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SHORT TERM DISABILITY TEMPORARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $30,326 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1662 | Additional information about fees paid to insurance broker | ADMINISTRATION | Insurance broker organization code? | 5 | Commission paid to Insurance Broker | USD $6,055 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 6 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 110 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $5,142 | Total amount of fees paid to insurance company | USD $470 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $51,482 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 470 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $5,142 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 7 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 81 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $3,505 | Total amount of fees paid to insurance company | USD $1,125 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | CRITICAL ILLNESS VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $17,558 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,505 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1125 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 8 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 88 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $3,886 | Total amount of fees paid to insurance company | USD $1,251 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENT ONLY VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $19,463 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,886 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1251 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 9 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 114 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $8,862 | Total amount of fees paid to insurance company | USD $4,668 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | TERM LIFE VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $44,392 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1662 | Additional information about fees paid to insurance broker | ADMINISTRATION | Insurance broker organization code? | 5 | Commission paid to Insurance Broker | USD $8,862 |
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WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
Policy contract number | ESL110039400 |
Policy instance | 10 |
Insurance contract or identification number | ESL110039400 | Number of Individuals Covered | 118 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | TRANSPLANT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $15,247 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
Policy contract number | ESL100154000 |
Policy instance | 11 |
Insurance contract or identification number | ESL100154000 | Number of Individuals Covered | 118 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $124,204 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 2 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 215 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-10-01 | Total amount of commissions paid to insurance broker | USD $2,776 | Total amount of fees paid to insurance company | USD $1,459 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $18,504 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1459 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $2,776 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | EA84 |
Policy instance | 1 |
Insurance contract or identification number | EA84 | Number of Individuals Covered | 1495 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $23,027 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | GUARANTEED INTEREST OPTION | Commission paid to Insurance Broker | USD $22,689 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | RELIA LIFE INSURANCE COMPANY COMMISSION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 7 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 112 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-10-01 | Total amount of commissions paid to insurance broker | USD $8,883 | Total amount of fees paid to insurance company | USD $4,535 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | TERM LIFE - VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $44,413 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 1662 | Additional information about fees paid to insurance broker | ADMINISTRATION | Insurance broker organization code? | 5 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 3 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 215 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-10-01 | Total amount of commissions paid to insurance broker | USD $626 | Total amount of fees paid to insurance company | USD $2,003 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,176 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 1662 | Additional information about fees paid to insurance broker | ADMINISTRATION | Insurance broker organization code? | 5 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 4 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 144 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-10-01 | Total amount of commissions paid to insurance broker | USD $6,243 | Total amount of fees paid to insurance company | USD $3,810 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SHORT TERM DISABILITY VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $31,217 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 1662 | Additional information about fees paid to insurance broker | ADMINISTRATION | Insurance broker organization code? | 5 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 5 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 85 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-10-01 | Total amount of commissions paid to insurance broker | USD $3,410 | Total amount of fees paid to insurance company | USD $1,095 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | CRITICAL ILLNESS VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $17,050 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,410 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1095 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 6 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 78 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-10-01 | Total amount of commissions paid to insurance broker | USD $3,918 | Total amount of fees paid to insurance company | USD $1,454 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENT ONLY VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $19,589 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,918 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0109513 |
Policy instance | 8 |
Insurance contract or identification number | 0109513 | Number of Individuals Covered | 202 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-09-30 | Total amount of commissions paid to insurance broker | USD $6,635 | Total amount of fees paid to insurance company | USD $5,025 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $841,012 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 4020 | Additional information about fees paid to insurance broker | 2020 PINNACLE MEDICAL RETENTION INCENTIVE RISK | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0109513 |
Policy instance | 2 |
Insurance contract or identification number | 0109513 | Number of Individuals Covered | 372 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $7,508 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $919,029 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,508 | Additional information about fees paid to insurance broker | AETNA LIFE INSURANCE CO. COMMISSION, SERVICE FEES, DIRECT AND INDIRECT COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 3 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 268 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-10-01 | Total amount of commissions paid to insurance broker | USD $3,071 | Total amount of fees paid to insurance company | USD $1,244 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $20,473 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,071 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1244 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 4 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 145 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-10-01 | Total amount of commissions paid to insurance broker | USD $5,854 | Total amount of fees paid to insurance company | USD $3,250 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SHORT TERM DISABILITY VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $29,271 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 1416 | Additional information about fees paid to insurance broker | ADMINISTRATION | Insurance broker organization code? | 5 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 5 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 268 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-10-01 | Total amount of commissions paid to insurance broker | USD $730 | Total amount of fees paid to insurance company | USD $1,719 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,867 | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 1416 | Additional information about fees paid to insurance broker | ADMINISTRATION | Insurance broker organization code? | 5 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 6 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 74 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-10-01 | Total amount of commissions paid to insurance broker | USD $2,857 | Total amount of fees paid to insurance company | USD $1,306 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | CRITICAL ILLNESS VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $14,286 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,857 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 8 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 120 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-10-01 | Total amount of commissions paid to insurance broker | USD $7,942 | Total amount of fees paid to insurance company | USD $4,140 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | TERM LIFE VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $39,708 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1416 | Additional information about fees paid to insurance broker | ADMINISTRATION | Insurance broker organization code? | 5 | Commission paid to Insurance Broker | USD $0 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | EA84 |
Policy instance | 1 |
Insurance contract or identification number | EA84 | Number of Individuals Covered | 1425 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $15,603 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | GUARANTEED INTEREST OPTION | Commission paid to Insurance Broker | USD $70 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | RELIASTAR LIFE INSURANCE COMPANY COMMISSION | Insurance broker organization code? | 3 |
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UNITED OF OMAHA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 7 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 81 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-10-01 | Total amount of commissions paid to insurance broker | USD $3,933 | Total amount of fees paid to insurance company | USD $1,349 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENT ONLY VOLUNTARY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $19,633 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 1349 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | EA84 |
Policy instance | 3 |
Insurance contract or identification number | EA84 | Number of Individuals Covered | 1425 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $14,155 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Other information about contract | GUARANTEED INTEREST OPTION | Commission paid to Insurance Broker | USD $69 | Additional information about fees paid to insurance broker | RELIASTAR LIFE INSURANCE COMPANY COMMISSION | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 0 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BF5G |
Policy instance | 1 |
Insurance contract or identification number | G000BF5G | Number of Individuals Covered | 229 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-10-01 | Total amount of commissions paid to insurance broker | USD $23,203 | Total amount of fees paid to insurance company | USD $6,392 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SHORT TERM DISABILITY ,CRITICAL ILLNESS, ACCIDENT ONLY, TERM LIFE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $121,114 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 4248 | Additional information about fees paid to insurance broker | MUTUAL OF OMAHA INSURANCE COMPANY COMMISSION AND FEES | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0109513 |
Policy instance | 2 |
Insurance contract or identification number | 0109513 | Number of Individuals Covered | 209 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-09-30 | Total amount of commissions paid to insurance broker | USD $6,007 | Total amount of fees paid to insurance company | USD $7,040 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $828,811 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,007 | Amount paid for insurance broker fees | 7040 | Additional information about fees paid to insurance broker | AETNA LIFE INSURANCE CO. COMMISSION, SERVICE FEES, DIRECT AND INDIRECT COMPENSATION. | Insurance broker organization code? | 3 |
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HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 ) |
Policy contract number | 747310 |
Policy instance | 2 |
Insurance contract or identification number | 747310 | Number of Individuals Covered | 100 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-09-30 | Total amount of commissions paid to insurance broker | USD $35,109 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $702,174 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00491050 |
Policy instance | 1 |
Insurance contract or identification number | 00491050 | Number of Individuals Covered | 196 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-09-30 | Total amount of commissions paid to insurance broker | USD $25,414 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENT,VOLUNTARY CRITICAL ILLNESS | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $157,114 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | EA84 |
Policy instance | 3 |
Insurance contract or identification number | EA84 | Number of Individuals Covered | 1449 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $14,365 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHAD |
Policy instance | 2 |
Insurance contract or identification number | G000AHAD | Number of Individuals Covered | 78 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-10-01 | Total amount of commissions paid to insurance broker | USD $483 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,413 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $483 | Insurance broker organization code? | 3 | Insurance broker name | HAMSTRA BENEFIT SOLUTIONS LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHAD |
Policy instance | 3 |
Insurance contract or identification number | G000AHAD | Number of Individuals Covered | 60 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-10-01 | Total amount of commissions paid to insurance broker | USD $2,753 | Are there contracts with allocated funds for individual policies? | Yes | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | PREFERRED CHOICE VOLUNTARY STD | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $13,767 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,753 | Insurance broker organization code? | 3 | Insurance broker name | HAMSTRA BENEFIT SOLUTIONS LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHAD |
Policy instance | 4 |
Insurance contract or identification number | G000AHAD | Number of Individuals Covered | 55 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-10-01 | Total amount of commissions paid to insurance broker | USD $2,923 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $14,613 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,923 | Insurance broker organization code? | 3 | Insurance broker name | HAMSTRA BENEFIT SOLUTIONS LLC |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | PC1D1251 |
Policy instance | 5 |
Insurance contract or identification number | PC1D1251 | Number of Individuals Covered | 34 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of commissions paid to insurance broker | USD $1,753 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $17,557 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,753 | Insurance broker name | JANNA L HAMSTRA |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 10774-1019 |
Policy instance | 6 |
Insurance contract or identification number | 10774-1019 | Number of Individuals Covered | 90 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of commissions paid to insurance broker | USD $507 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $5,065 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $507 | Insurance broker name | HAMSTRA BENEFITS |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | PTO 40082209 |
Policy instance | 7 |
Insurance contract or identification number | PTO 40082209 | Number of Individuals Covered | 1515 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHAD |
Policy instance | 1 |
Insurance contract or identification number | G000AHAD | Number of Individuals Covered | 78 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-10-01 | Total amount of commissions paid to insurance broker | USD $1,967 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $9,833 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,967 | Insurance broker organization code? | 3 | Insurance broker name | HAMSTRA BENEFIT SOLUTIONS LLC |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | FG1D1291 |
Policy instance | 1 |
Insurance contract or identification number | FG1D1291 | Number of Individuals Covered | 32 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Total amount of commissions paid to insurance broker | USD $1,391 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $13,880 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | PTO 40082209 |
Policy instance | 7 |
Insurance contract or identification number | PTO 40082209 | Number of Individuals Covered | 651 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHAD |
Policy instance | 6 |
Insurance contract or identification number | G000AHAD | Number of Individuals Covered | 56 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-10-01 | Total amount of commissions paid to insurance broker | USD $2,729 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $13,647 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHAD |
Policy instance | 5 |
Insurance contract or identification number | G000AHAD | Number of Individuals Covered | 84 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-10-01 | Total amount of commissions paid to insurance broker | USD $2,025 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $10,125 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHAD |
Policy instance | 4 |
Insurance contract or identification number | G000AHAD | Number of Individuals Covered | 84 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-10-01 | Total amount of commissions paid to insurance broker | USD $495 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,475 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AHAD |
Policy instance | 3 |
Insurance contract or identification number | G000AHAD | Number of Individuals Covered | 60 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-10-01 | Total amount of commissions paid to insurance broker | USD $2,668 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $13,341 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 10774-1019 |
Policy instance | 2 |
Insurance contract or identification number | 10774-1019 | Number of Individuals Covered | 79 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Total amount of commissions paid to insurance broker | USD $511 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $5,109 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 545266 |
Policy instance | 1 |
Insurance contract or identification number | 545266 | Number of Individuals Covered | 53 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $3,667 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GOOOAHAD |
Policy instance | 2 |
Insurance contract or identification number | GOOOAHAD | Number of Individuals Covered | 45 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-10-01 | Total amount of commissions paid to insurance broker | USD $2,206 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $11,030 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GOOOAHAD |
Policy instance | 3 |
Insurance contract or identification number | GOOOAHAD | Number of Individuals Covered | 81 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-10-01 | Total amount of commissions paid to insurance broker | USD $1,970 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $9,851 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GOOOAHAD |
Policy instance | 4 |
Insurance contract or identification number | GOOOAHAD | Number of Individuals Covered | 81 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-10-01 | Total amount of commissions paid to insurance broker | USD $482 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,412 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GOOOAHAD |
Policy instance | 5 |
Insurance contract or identification number | GOOOAHAD | Number of Individuals Covered | 60 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-10-01 | Total amount of commissions paid to insurance broker | USD $2,530 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $12,649 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 10774-1019 |
Policy instance | 6 |
Insurance contract or identification number | 10774-1019 | Number of Individuals Covered | 69 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $463 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,627 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | PTO 40082209 |
Policy instance | 7 |
Insurance contract or identification number | PTO 40082209 | Number of Individuals Covered | 1736 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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