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FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 401k Plan overview

Plan NameFRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN
Plan identification number 501

FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN Benefits

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

401k Sponsoring company profile

FRANK KENT MOTOR COMPANY, LP has sponsored the creation of one or more 401k plans.

Company Name:FRANK KENT MOTOR COMPANY, LP
Employer identification number (EIN):751235317
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01BRIAN DEAVER2023-11-29
5012021-05-01
5012020-05-01
5012019-05-01
5012018-05-01
5012017-05-01WILL CHURCHILL
5012016-05-01WILL CHURCHILL
5012015-05-01WILL CHURCHILL
5012013-05-01WILL CHURCHILL
5012012-05-01WILL CHURCHILL
5012011-05-01WILL CHURCHILL
5012009-05-01WILL CHURCHILL

Plan Statistics for FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN

401k plan membership statisitcs for FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN

Measure Date Value
2022: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01296
Total number of active participants reported on line 7a of the Form 55002022-05-01310
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01310
Number of employers contributing to the scheme2022-05-010
2021: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01326
Total number of active participants reported on line 7a of the Form 55002021-05-01296
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01296
2020: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01305
Total number of active participants reported on line 7a of the Form 55002020-05-01326
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01326
2019: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01240
Total number of active participants reported on line 7a of the Form 55002019-05-01305
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01305
2018: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01288
Total number of active participants reported on line 7a of the Form 55002018-05-01240
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01240
2017: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01228
Total number of active participants reported on line 7a of the Form 55002017-05-01288
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01288
2016: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01255
Total number of active participants reported on line 7a of the Form 55002016-05-01228
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01228
2015: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01565
Total number of active participants reported on line 7a of the Form 55002015-05-01255
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-01255
2013: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01524
Total number of active participants reported on line 7a of the Form 55002013-05-01607
Number of retired or separated participants receiving benefits2013-05-010
Number of other retired or separated participants entitled to future benefits2013-05-010
Total of all active and inactive participants2013-05-01607
2012: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01499
Total number of active participants reported on line 7a of the Form 55002012-05-01524
Number of retired or separated participants receiving benefits2012-05-010
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-01524
2011: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01462
Total number of active participants reported on line 7a of the Form 55002011-05-01499
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-01499
2009: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01275
Total number of active participants reported on line 7a of the Form 55002009-05-01516
Number of retired or separated participants receiving benefits2009-05-010
Number of other retired or separated participants entitled to future benefits2009-05-010
Total of all active and inactive participants2009-05-01516

Form 5500 Responses for FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN

2022: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – General assets of the sponsorYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – General assets of the sponsorYes
2019: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – General assets of the sponsorYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – General assets of the sponsorYes
2018: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – General assets of the sponsorYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – General assets of the sponsorYes
2017: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – General assets of the sponsorYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – General assets of the sponsorYes
2016: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – General assets of the sponsorYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – General assets of the sponsorYes
2015: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – General assets of the sponsorYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – General assets of the sponsorYes
2013: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – General assets of the sponsorYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – General assets of the sponsorYes
2012: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – General assets of the sponsorYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – General assets of the sponsorYes
2011: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – General assets of the sponsorYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – General assets of the sponsorYes
2009: FRANK KENT MOTOR CO EMPLOYEE HEALTH PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan funding arrangement – General assets of the sponsorYes
2009-05-01Plan benefit arrangement – InsuranceYes
2009-05-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract numberLBT
Policy instance 3
Insurance contract or identification numberLBT
Number of Individuals Covered50
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $9,422
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $30,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,125
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number334130
Policy instance 2
Insurance contract or identification number334130
Number of Individuals Covered166
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $1,469
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,604
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,469
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number953003
Policy instance 1
Insurance contract or identification number953003
Number of Individuals Covered346
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $51,935
Total amount of fees paid to insurance companyUSD $6,654
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $258,560
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,327
Amount paid for insurance broker fees6654
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number00
Policy instance 4
Insurance contract or identification number00
Number of Individuals Covered310
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $27,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number167429
Policy instance 3
Insurance contract or identification number167429
Number of Individuals Covered74
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $5,561
Welfare Benefit Premiums Paid to CarrierUSD $40,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,293
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BC9Y
Policy instance 2
Insurance contract or identification numberG000BC9Y
Number of Individuals Covered296
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $22,806
Total amount of fees paid to insurance companyUSD $10,653
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $132,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,365
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Amount paid for insurance broker fees10653
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number334130
Policy instance 1
Insurance contract or identification number334130
Number of Individuals Covered296
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $2,305
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,305
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417002414460
Policy instance 2
Insurance contract or identification number417002414460
Number of Individuals Covered176
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $438,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number334130
Policy instance 1
Insurance contract or identification number334130
Number of Individuals Covered164
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $2,211
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,211
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BC9Y
Policy instance 3
Insurance contract or identification numberG000BC9Y
Number of Individuals Covered326
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $26,337
Total amount of fees paid to insurance companyUSD $9,875
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $145,918
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,337
Amount paid for insurance broker fees8213
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number928305
Policy instance 4
Insurance contract or identification number928305
Number of Individuals Covered204
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $14,528
Total amount of fees paid to insurance companyUSD $1,124
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $133,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,528
Amount paid for insurance broker fees377
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number167429
Policy instance 5
Insurance contract or identification number167429
Number of Individuals Covered83
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $33,655
Welfare Benefit Premiums Paid to CarrierUSD $43,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,428
Insurance broker organization code?3
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number334130
Policy instance 1
Insurance contract or identification number334130
Number of Individuals Covered170
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $2,220
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,220
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40797
Policy instance 2
Insurance contract or identification numberHCCLOT40797
Number of Individuals Covered166
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $2,627
Total amount of fees paid to insurance companyUSD $946
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $26,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,627
Amount paid for insurance broker fees946
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BC9Y
Policy instance 3
Insurance contract or identification numberG000BC9Y
Number of Individuals Covered305
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $18,251
Total amount of fees paid to insurance companyUSD $4,652
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $150,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,251
Amount paid for insurance broker fees4652
Insurance broker organization code?3
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number0418300000
Policy instance 4
Insurance contract or identification number0418300000
Number of Individuals Covered44
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $3,886
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $19,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,886
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number0418300000
Policy instance 5
Insurance contract or identification number0418300000
Number of Individuals Covered26
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $4,403
Other welfare benefits providedCRITICAL HEALTH EVENTS
Welfare Benefit Premiums Paid to CarrierUSD $19,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,403
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number928305
Policy instance 6
Insurance contract or identification number928305
Number of Individuals Covered179
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $12,908
Total amount of fees paid to insurance companyUSD $1,124
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $128,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,908
Amount paid for insurance broker fees638
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number1601348100
Policy instance 7
Insurance contract or identification number1601348100
Number of Individuals Covered166
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Welfare Benefit Premiums Paid to CarrierUSD $343,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number0418300000
Policy instance 6
Insurance contract or identification number0418300000
Number of Individuals Covered51
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $5,363
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $17,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,363
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BC9Y
Policy instance 5
Insurance contract or identification numberG000BC9Y
Number of Individuals Covered240
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $23,951
Total amount of fees paid to insurance companyUSD $10,201
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $138,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,951
Amount paid for insurance broker fees10201
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-013481-00
Policy instance 4
Insurance contract or identification number16-013481-00
Number of Individuals Covered154
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Welfare Benefit Premiums Paid to CarrierUSD $323,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5480323
Policy instance 3
Insurance contract or identification number5480323
Number of Individuals Covered167
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $11,688
Total amount of fees paid to insurance companyUSD $1,006
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $113,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,688
Amount paid for insurance broker fees645
Insurance broker organization code?3
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-6615
Policy instance 2
Insurance contract or identification number947-6615
Number of Individuals Covered151
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $2,601
Total amount of fees paid to insurance companyUSD $936
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $26,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,601
Amount paid for insurance broker fees936
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number334130
Policy instance 1
Insurance contract or identification number334130
Number of Individuals Covered141
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $1,822
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,822
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05735706
Policy instance 2
Insurance contract or identification numberKM05735706
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $5,525
Total amount of fees paid to insurance companyUSD $409
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,227
Amount paid for insurance broker fees409
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameJOE BITZ
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number334130
Policy instance 1
Insurance contract or identification number334130
Number of Individuals Covered288
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $1,555
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,555
Insurance broker nameGBC BENEFITS, LTD.
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-5124
Policy instance 3
Insurance contract or identification number947-5124
Number of Individuals Covered205
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $3,285
Total amount of fees paid to insurance companyUSD $1,182
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $32,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,285
Amount paid for insurance broker fees1182
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameGPA
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5480323
Policy instance 4
Insurance contract or identification number5480323
Number of Individuals Covered228
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $19,566
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $166,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,566
Insurance broker organization code?3
Insurance broker nameGBC BENEFITS, LTD.
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-013481-00
Policy instance 5
Insurance contract or identification number16-013481-00
Number of Individuals Covered205
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Welfare Benefit Premiums Paid to CarrierUSD $271,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract numberIHCRS-00095-15
Policy instance 1
Insurance contract or identification numberIHCRS-00095-15
Number of Individuals Covered165
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Welfare Benefit Premiums Paid to CarrierUSD $250,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-1204
Policy instance 2
Insurance contract or identification number947-1204
Number of Individuals Covered165
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $2,657
Other welfare benefits providedOTHER (SPECIFY) TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $26,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,657
Insurance broker organization code?3
Insurance broker nameGPA
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05735706
Policy instance 3
Insurance contract or identification numberKM05735706
Number of Individuals Covered255
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $22,738
Total amount of fees paid to insurance companyUSD $2,039
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $160,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,411
Amount paid for insurance broker fees2039
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameJOE BITZ
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract numberIHCRS-00095-13
Policy instance 1
Insurance contract or identification numberIHCRS-00095-13
Number of Individuals Covered187
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Welfare Benefit Premiums Paid to CarrierUSD $276,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number949-5992
Policy instance 2
Insurance contract or identification number949-5992
Number of Individuals Covered187
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $3,368
Other welfare benefits providedOTHER (SPECIFY) TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $33,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,368
Insurance broker organization code?3
Insurance broker nameGPA
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05735706
Policy instance 3
Insurance contract or identification numberKM05735706
Number of Individuals Covered607
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $27,513
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $226,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,037
Insurance broker organization code?3
Insurance broker nameJOE BITZ
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number949-3305
Policy instance 2
Insurance contract or identification number949-3305
Number of Individuals Covered187
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $2,882
Other welfare benefits providedOTHER (SPECIFY) TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $28,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,882
Insurance broker organization code?3
Insurance broker nameGPA
KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )
Policy contract numberK100831001
Policy instance 1
Insurance contract or identification numberK100831001
Number of Individuals Covered190
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $50,904
Welfare Benefit Premiums Paid to CarrierUSD $363,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,904
Insurance broker organization code?3
Insurance broker nameGBC BENEFITS, LTD
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05735706
Policy instance 3
Insurance contract or identification numberKM05735706
Number of Individuals Covered524
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $18,896
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $145,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,448
Insurance broker organization code?3
Insurance broker nameJOE BITZ
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number280-840
Policy instance 2
Insurance contract or identification number280-840
Number of Individuals Covered180
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $2,518
Other welfare benefits providedOTHER SPECIFY TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $22,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract number5010-9002-265
Policy instance 1
Insurance contract or identification number5010-9002-265
Number of Individuals Covered177
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $49,956
Welfare Benefit Premiums Paid to CarrierUSD $356,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05735706
Policy instance 3
Insurance contract or identification numberKM05735706
Number of Individuals Covered499
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $17,156
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $145,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract number5010-9002-265
Policy instance 1
Insurance contract or identification number5010-9002-265
Number of Individuals Covered152
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $40,616
Welfare Benefit Premiums Paid to CarrierUSD $290,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05735706
Policy instance 3
Insurance contract or identification numberKM05735706
Number of Individuals Covered462
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $16,004
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $121,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number280-840
Policy instance 2
Insurance contract or identification number280-840
Number of Individuals Covered152
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $1,997
Other welfare benefits providedOTHER SPECIFY TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $19,978
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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