LEGACY HOME HEALTH AGENCY, INC. has sponsored the creation of one or more 401k plans.
Additional information about LEGACY HOME HEALTH AGENCY, INC.
Submission information for form 5500 for 401k plan LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL
401k plan membership statisitcs for LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL
| Measure | Date | Value |
|---|
| 2021: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 139 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 111 |
| Total of all active and inactive participants | 2021-01-01 | 111 |
| 2020: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 121 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 139 |
| Total of all active and inactive participants | 2020-01-01 | 139 |
| 2019: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 121 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 121 |
| Total of all active and inactive participants | 2019-01-01 | 121 |
| 2018: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 80 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 121 |
| Total of all active and inactive participants | 2018-01-01 | 121 |
| 2017: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 177 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 80 |
| Total of all active and inactive participants | 2017-01-01 | 80 |
| 2016: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 194 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 177 |
| Total of all active and inactive participants | 2016-01-01 | 177 |
| 2015: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 189 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 194 |
| Total of all active and inactive participants | 2015-01-01 | 194 |
| 2014: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 255 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 189 |
| Total of all active and inactive participants | 2014-01-01 | 189 |
| 2013: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 157 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 255 |
| Total of all active and inactive participants | 2013-01-01 | 255 |
| 2012: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 190 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 157 |
| Total of all active and inactive participants | 2012-01-01 | 157 |
| 2011: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-09-01 | 223 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 190 |
| Total of all active and inactive participants | 2011-09-01 | 190 |
| 2009: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-09-01 | 197 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 173 |
| Total of all active and inactive participants | 2009-09-01 | 173 |
| 2008: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-09-01 | 193 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-09-01 | 197 |
| Total of all active and inactive participants | 2008-09-01 | 197 |
| 2007: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-09-01 | 141 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-09-01 | 193 |
| Total of all active and inactive participants | 2007-09-01 | 193 |
| 2021: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | This submission is the final filing | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2011 form 5500 responses |
|---|
| 2011-09-01 | Type of plan entity | Single employer plan |
| 2011-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2011-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2009 form 5500 responses |
|---|
| 2009-09-01 | Type of plan entity | Single employer plan |
| 2009-09-01 | This submission is the final filing | No |
| 2009-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2008 form 5500 responses |
|---|
| 2008-09-01 | Type of plan entity | Single employer plan |
| 2008-09-01 | This submission is the final filing | No |
| 2008-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2007: LEGACY HOME HEALTH AGENCY, INC. WELFARE BENEFIT PL 2007 form 5500 responses |
|---|
| 2007-09-01 | Type of plan entity | Single employer plan |
| 2007-09-01 | This submission is the final filing | No |
| 2007-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1094066 |
| Policy instance | 2 |
| Insurance contract or identification number | 1094066 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $4,641 | | Total amount of fees paid to insurance company | USD $389 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,751 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,641 | | Amount paid for insurance broker fees | 389 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 242766 |
| Policy instance | 1 |
| Insurance contract or identification number | 242766 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $13,385 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $273,393 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,385 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 242766 |
| Policy instance | 1 |
| Insurance contract or identification number | 242766 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $13,774 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $274,399 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,774 | | Insurance broker organization code? | 3 |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1094066 |
| Policy instance | 2 |
| Insurance contract or identification number | 1094066 | | Number of Individuals Covered | 139 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $4,903 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,377 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,903 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 242766 |
| Policy instance | 1 |
| Insurance contract or identification number | 242766 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $14,265 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $291,861 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,265 | | Insurance broker organization code? | 3 |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1094066 |
| Policy instance | 2 |
| Insurance contract or identification number | 1094066 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $4,769 | | Total amount of fees paid to insurance company | USD $1,928 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,204 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,769 | | Amount paid for insurance broker fees | 1928 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 ) |
| Policy contract number | 785169 |
| Policy instance | 1 |
| Insurance contract or identification number | 785169 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $5,595 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $85,620 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,595 | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 785169 |
| Policy instance | 2 |
| Insurance contract or identification number | 785169 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $1,134 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,249 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $886 | | Additional information about fees paid to insurance broker | DENTAL | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05997074 |
| Policy instance | 3 |
| Insurance contract or identification number | KM05997074 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $1,204 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,966 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,204 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 188062 |
| Policy instance | 3 |
| Insurance contract or identification number | 188062 | | Number of Individuals Covered | 62 | | Insurance policy start date | 2016-06-01 | | Insurance policy end date | 2017-05-31 | | Total amount of commissions paid to insurance broker | USD $23,397 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $448,599 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,397 | | Insurance broker organization code? | 3 | | Insurance broker name | THE HILB GROUP OF TEXAS |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 785169 |
| Policy instance | 2 |
| Insurance contract or identification number | 785169 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $3,837 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,464 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,458 | | Additional information about fees paid to insurance broker | DENTAL | | Insurance broker name | |
|
| HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 ) |
| Policy contract number | 785169 |
| Policy instance | 1 |
| Insurance contract or identification number | 785169 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $8,347 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $179,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,347 | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN FINANCIAL INSURANCE SER IN |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05997074 |
| Policy instance | 4 |
| Insurance contract or identification number | KM05997074 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $1,204 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,966 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,204 | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN FINANCIAL INSURANCE SER IN |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05997074 |
| Policy instance | 2 |
| Insurance contract or identification number | KM05997074 | | Number of Individuals Covered | 194 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $5,028 | | Total amount of fees paid to insurance company | USD $688 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $54,913 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,509 | | Amount paid for insurance broker fees | 688 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN FINANCIAL INSURANCE SERVIC |
|
| HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 ) |
| Policy contract number | 740785 |
| Policy instance | 1 |
| Insurance contract or identification number | 740785 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $22,906 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $397,767 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,806 | | Insurance broker organization code? | 3 | | Insurance broker name | YOURPEOPLE INC DBA ZENEFITS FTW INC |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05997074 |
| Policy instance | 2 |
| Insurance contract or identification number | KM05997074 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,942 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $53,285 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,942 | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN FINANCIAL INSURANCE SVC, I |
|
| BLUECROSS BLUESHIELD OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 008961 |
| Policy instance | 1 |
| Insurance contract or identification number | 008961 | | Number of Individuals Covered | 85 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $20,272 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $416,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,272 | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN FINANCIAL INSURANCE SVC, I |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05997074 |
| Policy instance | 2 |
| Insurance contract or identification number | KM05997074 | | Number of Individuals Covered | 255 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $9,588 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $119,703 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,543 | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN FINANCIAL INSURANCE SVC, I |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 008961 |
| Policy instance | 1 |
| Insurance contract or identification number | 008961 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $30,408 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $616,678 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,621 | | Insurance broker organization code? | 3 | | Insurance broker name | WALKER MYERS INS & RISK MGMT LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00451393 |
| Policy instance | 1 |
| Insurance contract or identification number | 00451393 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $6,946 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $97,711 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,636 | | Insurance broker organization code? | 3 | | Insurance broker name | WALKER MYERS INS & RISK MGMT LLC |
|
| KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 ) |
| Policy contract number | 7209131000 |
| Policy instance | 3 |
| Insurance contract or identification number | 7209131000 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,219 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | CANCER, AD&D & CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $22,437 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,261 | | Insurance broker organization code? | 3 | | Insurance broker name | DENISE S VILLAGRAN |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 008961 |
| Policy instance | 2 |
| Insurance contract or identification number | 008961 | | Number of Individuals Covered | 152 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $24,483 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $489,669 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,483 | | Insurance broker organization code? | 3 | | Insurance broker name | WALKER MYERS INS & RISK MGMT LLC |
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| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 008961 |
| Policy instance | 2 |
| Insurance contract or identification number | 008961 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $10,323 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $206,460 | | 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 | 00451393 |
| Policy instance | 1 |
| Insurance contract or identification number | 00451393 | | Number of Individuals Covered | 173 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,653 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $38,780 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 ) |
| Policy contract number | 7209131000 |
| Policy instance | 3 |
| Insurance contract or identification number | 7209131000 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $929 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | CANCER, AD&D & CRITICAL ILLNESS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 ) |
| Policy contract number | 7209131000 |
| Policy instance | 3 |
| Insurance contract or identification number | 7209131000 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $8,852 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | CANCER, AD&D & CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $19,956 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 008961 |
| Policy instance | 2 |
| Insurance contract or identification number | 008961 | | Number of Individuals Covered | 223 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $32,635 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $721,841 | | 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 | 00451393 |
| Policy instance | 1 |
| Insurance contract or identification number | 00451393 | | Number of Individuals Covered | 201 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $7,747 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $100,309 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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