COMMERCIAL BANK OF TEXAS, N.A. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN
401k plan membership statisitcs for COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN
| Measure | Date | Value |
|---|
| 2018: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 165 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 183 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 183 |
| 2017: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 165 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 165 |
| 2016: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 117 |
| Total of all active and inactive participants | 2016-01-01 | 117 |
| Total participants | 2016-01-01 | 117 |
| 2015: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 199 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 212 |
| Total of all active and inactive participants | 2015-01-01 | 212 |
| Total participants | 2015-01-01 | 0 |
| 2014: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 164 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 199 |
| Total of all active and inactive participants | 2014-01-01 | 199 |
| Total participants | 2014-01-01 | 0 |
| 2013: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 139 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 164 |
| Total of all active and inactive participants | 2013-01-01 | 164 |
| Total participants | 2013-01-01 | 0 |
| 2012: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 139 |
| Total of all active and inactive participants | 2012-01-01 | 139 |
| Total participants | 2012-01-01 | 0 |
| 2011: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 132 |
| Total of all active and inactive participants | 2011-01-01 | 132 |
| Total participants | 2011-01-01 | 132 |
| 2010: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 125 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 120 |
| Total of all active and inactive participants | 2010-01-01 | 120 |
| Total participants | 2010-01-01 | 120 |
| 2009: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 125 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 125 |
| Total of all active and inactive participants | 2009-01-01 | 125 |
| Total participants | 2009-01-01 | 125 |
| 2018: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 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 – Insurance | Yes |
| 2017: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 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 – Insurance | Yes |
| 2016: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 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 – Insurance | Yes |
| 2015: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 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 – Insurance | Yes |
| 2014: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 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 – Insurance | Yes |
| 2012: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 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 – Insurance | Yes |
| 2011: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: COMMERCIAL BANK OF TEXAS, N.A. TERM LIFE AND AD&D INSURANCE PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
| Policy contract number | 141002 |
| Policy instance | 1 |
| Insurance contract or identification number | 141002 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $300 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,259 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $300 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
| Policy contract number | 141002 |
| Policy instance | 1 |
| Insurance contract or identification number | 141002 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $528 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,378 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $528 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | COMMERCIAL BANK OF TEXAS NAT. ASSOC |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | G69552 |
| Policy instance | 1 |
| Insurance contract or identification number | G69552 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $2,161 | | Total amount of fees paid to insurance company | USD $182 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD, LTDSUP | | Welfare Benefit Premiums Paid to Carrier | USD $49,743 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,161 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 182 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker name | FRIESEN-STRAIN INSURANCE |
|
| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
| Policy contract number | 141002 |
| Policy instance | 2 |
| Insurance contract or identification number | 141002 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $408 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,988 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $408 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMERCIAL BANK OF TEXAS N.A. |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 080270089549 |
| Policy instance | 3 |
| Insurance contract or identification number | 080270089549 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $84,660 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,244,192 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $60,815 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker name | FRIESEN-STRAIN INSURANCE ASSOC. |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | ER00012419 |
| Policy instance | 4 |
| Insurance contract or identification number | ER00012419 | | Number of Individuals Covered | 212 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $6,818 | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $28,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,792 | | Insurance broker organization code? | 3 | | Insurance broker name | FRIESEN-STRAIN INSURANCE ASSOC. |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30053923 |
| Policy instance | 5 |
| Insurance contract or identification number | 30053923 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,501 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | H1ZM |
| Policy instance | 5 |
| Insurance contract or identification number | H1ZM | | Number of Individuals Covered | 52 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $77 | | Total amount of fees paid to insurance company | USD $26 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,023 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $52 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 26 | | Insurance broker name | FRIESEN-STRAIN INSURANCE |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | ER00012419 |
| Policy instance | 4 |
| Insurance contract or identification number | ER00012419 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $8,597 | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $39,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,998 | | Insurance broker organization code? | 3 | | Insurance broker name | FRIESEN-STRAIN INSURANCE ASSOC. |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 080270089549 |
| Policy instance | 3 |
| Insurance contract or identification number | 080270089549 | | Number of Individuals Covered | 199 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $83,506 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,214,370 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $60,017 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker name | FRIESEN-STRAIN INSURANCE ASSOC. |
|
| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
| Policy contract number | 141002 |
| Policy instance | 2 |
| Insurance contract or identification number | 141002 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $414 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,166 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $414 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMERCIAL BANK OF TEXAS N.A. |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | G69552 |
| Policy instance | 1 |
| Insurance contract or identification number | G69552 | | Number of Individuals Covered | 146 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $4,509 | | Total amount of fees paid to insurance company | USD $434 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD, LTDSUP | | Welfare Benefit Premiums Paid to Carrier | USD $45,086 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,509 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 434 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker name | FRIESEN-STRAIN INSURANCE |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | ER00012419 |
| Policy instance | 4 |
| Insurance contract or identification number | ER00012419 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $5,028 | | Welfare Benefit Premiums Paid to Carrier | USD $26,561 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,564 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker name | FRIESEN-STRAIN INSURANCE ASSOC. |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 080270089549 |
| Policy instance | 3 |
| Insurance contract or identification number | 080270089549 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $51,104 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $927,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $51,104 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMERCIAL BANK OF TEXAS N.A. |
|
| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
| Policy contract number | 141002 |
| Policy instance | 2 |
| Insurance contract or identification number | 141002 | | Number of Individuals Covered | 139 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $402 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,013 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $402 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMERCIAL BANK OF TEXAS N.A. |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | G69552 |
| Policy instance | 1 |
| Insurance contract or identification number | G69552 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $4,333 | | Total amount of fees paid to insurance company | USD $426 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD, LTDSUP | | Welfare Benefit Premiums Paid to Carrier | USD $43,331 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,333 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 426 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker name | FRIESEN-STRAIN INSURANCE |
|
| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
| Policy contract number | 141002 |
| Policy instance | 2 |
| Insurance contract or identification number | 141002 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $412 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,101 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $412 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker organization code? | 3 | | Insurance broker name | COMMERCIAL BANK OF TEXAS N.A. |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 242686 |
| Policy instance | 3 |
| Insurance contract or identification number | 242686 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $869 | | Total amount of fees paid to insurance company | USD $289 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,791 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $116 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 289 | | Insurance broker name | COMMERCIAL BANK OF TEXAS N.A. |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | G69552 |
| Policy instance | 4 |
| Insurance contract or identification number | G69552 | | Number of Individuals Covered | 139 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,153 | | Total amount of fees paid to insurance company | USD $409 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD, LTDSUP | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 409 | | Additional information about fees paid to insurance broker | MARKETING | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $4,153 | | Insurance broker name | JOHN R STILL |
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| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 080270089549 |
| Policy instance | 1 |
| Insurance contract or identification number | 080270089549 | | Number of Individuals Covered | 194 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $46,459 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $845,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,459 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMERCIAL BANK OF TEXAS N.A. |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 242686 |
| Policy instance | 1 |
| Insurance contract or identification number | 242686 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $669 | | Total amount of fees paid to insurance company | USD $223 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,460 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | G69552 |
| Policy instance | 2 |
| Insurance contract or identification number | G69552 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $3,536 | | Total amount of fees paid to insurance company | USD $354 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD, LTDSUP | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
| Policy contract number | 141002 |
| Policy instance | 1 |
| Insurance contract or identification number | 141002 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $364 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,625 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $364 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMERCIAL BANK OF TEXAS N.A. |
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