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FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 401k Plan overview

Plan NameFOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE
Plan identification number 502

FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 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)

401k Sponsoring company profile

FOUNDATION MANAGEMENT SERVICES INC. has sponsored the creation of one or more 401k plans.

Company Name:FOUNDATION MANAGEMENT SERVICES INC.
Employer identification number (EIN):752614434
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022018-01-01YOLANDE HILLIARD2020-04-14
5022018-01-01YOLANDE HILLIARD2020-10-14
5022017-01-01
5022015-12-01
5022014-12-01
5022013-12-01
5022013-03-01
5022012-03-01CINDY BROADUS
5022011-03-01CINDY BROADUS
5022010-03-01CINDY BROADUS
5022009-03-01CINDY BROADUS

Plan Statistics for FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE

401k plan membership statisitcs for FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE

Measure Date Value
2018: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2018 401k membership
Total participants, beginning-of-year2018-01-01820
Total number of active participants reported on line 7a of the Form 55002018-01-01318
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01318
Number of employers contributing to the scheme2018-01-010
2017: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2017 401k membership
Total participants, beginning-of-year2017-01-01781
Total number of active participants reported on line 7a of the Form 55002017-01-01820
Total of all active and inactive participants2017-01-01820
2015: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2015 401k membership
Total participants, beginning-of-year2015-12-01334
Total number of active participants reported on line 7a of the Form 55002015-12-01781
Total of all active and inactive participants2015-12-01781
2014: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2014 401k membership
Total participants, beginning-of-year2014-12-01473
Total number of active participants reported on line 7a of the Form 55002014-12-01334
Total of all active and inactive participants2014-12-01334
2013: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2013 401k membership
Total participants, beginning-of-year2013-12-01451
Total number of active participants reported on line 7a of the Form 55002013-12-01473
Total of all active and inactive participants2013-12-01473
Total participants2013-12-01473
Total participants, beginning-of-year2013-03-01473
Total number of active participants reported on line 7a of the Form 55002013-03-01451
Number of retired or separated participants receiving benefits2013-03-010
Total of all active and inactive participants2013-03-01451
Total participants2013-03-01451
2012: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2012 401k membership
Total participants, beginning-of-year2012-03-01473
Total of all active and inactive participants2012-03-010
Total participants2012-03-010
2011: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2011 401k membership
Total participants, beginning-of-year2011-03-01460
Total number of active participants reported on line 7a of the Form 55002011-03-01473
Total of all active and inactive participants2011-03-01473
Total participants2011-03-01473
2010: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2010 401k membership
Total participants, beginning-of-year2010-03-01419
Total number of active participants reported on line 7a of the Form 55002010-03-01460
Total of all active and inactive participants2010-03-01460
Total participants2010-03-01460
2009: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2009 401k membership
Total participants, beginning-of-year2009-03-01484
Total number of active participants reported on line 7a of the Form 55002009-03-01419
Total of all active and inactive participants2009-03-01419
Total participants2009-03-01419

Financial Data on FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE

Measure Date Value
2017 : FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2017 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31No
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
2016 : FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2016 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-11-30No
Was this plan covered by a fidelity bond2016-11-30No
If this is an individual account plan, was there a blackout period2016-11-30No
Were there any nonexempt tranactions with any party-in-interest2016-11-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-11-30No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-11-30No
Were any leases to which the plan was party in default or uncollectible2016-11-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-11-30No
Was there a failure to transmit to the plan any participant contributions2016-11-30No
Has the plan failed to provide any benefit when due under the plan2016-11-30No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-11-30No
Did the plan have assets held for investment2016-11-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-11-30No
2013 : FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2013 401k financial data
Total income from all sources (including contributions)2013-02-28$5,703,975
Total of all expenses incurred2013-02-28$5,677,269
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-02-28$5,554,830
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-02-28$5,180,209
Value of total assets at end of year2013-02-28$27,928
Value of total assets at beginning of year2013-02-28$1,222
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-02-28$122,439
Total interest from all sources2013-02-28$171
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-02-28Yes
Was this plan covered by a fidelity bond2013-02-28Yes
Value of fidelity bond cover2013-02-28$500,000
Were there any nonexempt tranactions with any party-in-interest2013-02-28No
Contributions received from participants2013-02-28$1,440,281
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-02-28$130,009
Other income not declared elsewhere2013-02-28$523,595
Total non interest bearing cash at end of year2013-02-28$27,928
Total non interest bearing cash at beginning of year2013-02-28$1,222
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-02-28No
Value of net income/loss2013-02-28$26,706
Value of net assets at end of year (total assets less liabilities)2013-02-28$27,928
Value of net assets at beginning of year (total assets less liabilities)2013-02-28$1,222
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2013-02-28No
Were any leases to which the plan was party in default or uncollectible2013-02-28No
Value of interest in common/collective trusts at end of year2013-02-28$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-02-28$171
Expenses. Payments to insurance carriers foe the provision of benefits2013-02-28$494,629
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-02-28No
Was there a failure to transmit to the plan any participant contributions2013-02-28No
Has the plan failed to provide any benefit when due under the plan2013-02-28No
Contributions received in cash from employer2013-02-28$3,739,928
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-02-28$4,930,192
Contract administrator fees2013-02-28$122,439
Did the plan have assets held for investment2013-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-02-28No
Opinion of an independent qualified public accountant for this plan2013-02-28Unqualified
Accountancy firm name2013-02-28BUMGARDNER, MORRISON & COMPANY, LLP
Accountancy firm EIN2013-02-28741194944
2012 : FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2012 401k financial data
Total income from all sources (including contributions)2012-02-29$5,972,820
Total of all expenses incurred2012-02-29$6,106,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-02-29$5,983,578
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-02-29$5,214,084
Value of total assets at end of year2012-02-29$1,222
Value of total assets at beginning of year2012-02-29$134,562
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-02-29$122,582
Total interest from all sources2012-02-29$554
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-02-29No
Was this plan covered by a fidelity bond2012-02-29Yes
Value of fidelity bond cover2012-02-29$500,000
Were there any nonexempt tranactions with any party-in-interest2012-02-29No
Contributions received from participants2012-02-29$1,536,396
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-02-29$121,541
Other income not declared elsewhere2012-02-29$758,182
Total non interest bearing cash at end of year2012-02-29$1,222
Total non interest bearing cash at beginning of year2012-02-29$134,562
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-02-29No
Value of net income/loss2012-02-29$-133,340
Value of net assets at end of year (total assets less liabilities)2012-02-29$1,222
Value of net assets at beginning of year (total assets less liabilities)2012-02-29$134,562
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2012-02-29No
Were any leases to which the plan was party in default or uncollectible2012-02-29No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-02-29$554
Expenses. Payments to insurance carriers foe the provision of benefits2012-02-29$430,414
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-02-29No
Was there a failure to transmit to the plan any participant contributions2012-02-29No
Has the plan failed to provide any benefit when due under the plan2012-02-29No
Contributions received in cash from employer2012-02-29$3,677,688
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-02-29$5,431,623
Contract administrator fees2012-02-29$122,582
Did the plan have assets held for investment2012-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-02-29No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-02-29No
Opinion of an independent qualified public accountant for this plan2012-02-29Unqualified
Accountancy firm name2012-02-29BUMGARDNER, MORRISON & COMPANY, LLP
Accountancy firm EIN2012-02-29741194944
2011 : FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2011 401k financial data
Total income from all sources (including contributions)2011-02-28$6,428,181
Total of all expenses incurred2011-02-28$6,527,921
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-02-28$6,415,185
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-02-28$5,937,289
Value of total assets at end of year2011-02-28$134,562
Value of total assets at beginning of year2011-02-28$234,302
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-02-28$112,736
Total interest from all sources2011-02-28$774
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-02-28No
Was this plan covered by a fidelity bond2011-02-28Yes
Value of fidelity bond cover2011-02-28$100,000
Were there any nonexempt tranactions with any party-in-interest2011-02-28No
Contributions received from participants2011-02-28$4,090,489
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-02-28$103,667
Other income not declared elsewhere2011-02-28$490,118
Total non interest bearing cash at end of year2011-02-28$134,562
Total non interest bearing cash at beginning of year2011-02-28$234,302
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Value of net income/loss2011-02-28$-99,740
Value of net assets at end of year (total assets less liabilities)2011-02-28$134,562
Value of net assets at beginning of year (total assets less liabilities)2011-02-28$234,302
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2011-02-28No
Were any leases to which the plan was party in default or uncollectible2011-02-28No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-02-28$774
Expenses. Payments to insurance carriers foe the provision of benefits2011-02-28$395,017
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-02-28No
Was there a failure to transmit to the plan any participant contributions2011-02-28No
Has the plan failed to provide any benefit when due under the plan2011-02-28No
Contributions received in cash from employer2011-02-28$1,846,800
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-02-28$5,916,501
Contract administrator fees2011-02-28$112,736
Did the plan have assets held for investment2011-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-02-28No
Opinion of an independent qualified public accountant for this plan2011-02-28Unqualified
Accountancy firm name2011-02-28BUMGARDNER, MORRISON & COMPANY, LLP
Accountancy firm EIN2011-02-28741194944

Form 5500 Responses for FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE

2018: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
2018-01-01This submission is the final filingYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2015: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan benefit arrangement – InsuranceYes
2014: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan benefit arrangement – InsuranceYes
2013: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2013 form 5500 responses
2013-12-01Type of plan entitySingle employer plan
2013-12-01Submission has been amendedNo
2013-12-01This submission is the final filingNo
2013-12-01This return/report is a short plan year return/report (less than 12 months)No
2013-12-01Plan is a collectively bargained planNo
2013-12-01Plan funding arrangement – InsuranceYes
2013-12-01Plan benefit arrangement – InsuranceYes
2013-03-01Type of plan entitySingle employer plan
2013-03-01Submission has been amendedNo
2013-03-01This submission is the final filingNo
2013-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-03-01Plan is a collectively bargained planNo
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan funding arrangement – TrustYes
2012-03-01Plan funding arrangement – General assets of the sponsorYes
2012-03-01Plan benefit arrangement – InsuranceYes
2012-03-01Plan benefit arrangement - TrustYes
2011: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan funding arrangement – TrustYes
2011-03-01Plan funding arrangement – General assets of the sponsorYes
2011-03-01Plan benefit arrangement – InsuranceYes
2011-03-01Plan benefit arrangement - TrustYes
2010: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2010 form 5500 responses
2010-03-01Type of plan entitySingle employer plan
2010-03-01Plan funding arrangement – InsuranceYes
2010-03-01Plan funding arrangement – TrustYes
2010-03-01Plan funding arrangement – General assets of the sponsorYes
2010-03-01Plan benefit arrangement – InsuranceYes
2010-03-01Plan benefit arrangement - TrustYes
2009: FOUNDATION MANAGEMENT SERVICES, INC. EMPLOYEE BENE 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan funding arrangement – TrustYes
2009-03-01Plan funding arrangement – General assets of the sponsorYes
2009-03-01Plan benefit arrangement – InsuranceYes
2009-03-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number197509
Policy instance 1
Insurance contract or identification number197509
Number of Individuals Covered406
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $73,139
Total amount of fees paid to insurance companyUSD $10
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,567,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $73,139
Amount paid for insurance broker fees10
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5921660
Policy instance 2
Insurance contract or identification number5921660
Number of Individuals Covered747
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $62,474
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $635,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $62,474
Amount paid for insurance broker fees0
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00010263
Policy instance 3
Insurance contract or identification numberER00010263
Number of Individuals Covered81
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,397
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,037
Amount paid for insurance broker fees0
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00010263
Policy instance 1
Insurance contract or identification numberER00010263
Number of Individuals Covered761
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $12,033
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,041
Insurance broker organization code?3
Insurance broker nameSCU HOUSE ACCT CHARLENE JORDAN
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5921660
Policy instance 2
Insurance contract or identification number5921660
Number of Individuals Covered820
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $58,643
Total amount of fees paid to insurance companyUSD $727
Dental Insurance Welfare BenefitYes
Vision 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 $668,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,643
Amount paid for insurance broker fees727
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION FOR ADMINISTRATION
Insurance broker organization code?3
Insurance broker nameCHARLES D WAITS JR
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number197509
Policy instance 3
Insurance contract or identification number197509
Number of Individuals Covered478
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $47,728
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,388,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,728
Insurance broker organization code?3
Insurance broker nameLOCTON COMPANIES LLC

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