PROJECT HIRED has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PROJECT HIRED HEALTH AND WELFARE TRUST PLAN
| Measure | Date | Value |
|---|
| 2020: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-02-01 | 28 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 0 |
| Number of retired or separated participants receiving benefits | 2020-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-02-01 | 0 |
| Total of all active and inactive participants | 2020-02-01 | 0 |
| 2019: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-02-01 | 30 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 29 |
| Number of retired or separated participants receiving benefits | 2019-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-02-01 | 0 |
| Total of all active and inactive participants | 2019-02-01 | 29 |
| 2018: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-02-01 | 35 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 30 |
| Number of retired or separated participants receiving benefits | 2018-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-02-01 | 0 |
| Total of all active and inactive participants | 2018-02-01 | 30 |
| 2017: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-02-01 | 31 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 35 |
| Number of retired or separated participants receiving benefits | 2017-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-02-01 | 0 |
| Total of all active and inactive participants | 2017-02-01 | 35 |
| 2016: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-02-01 | 36 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 31 |
| Number of retired or separated participants receiving benefits | 2016-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-02-01 | 0 |
| Total of all active and inactive participants | 2016-02-01 | 31 |
| 2015: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-02-01 | 35 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 36 |
| Number of retired or separated participants receiving benefits | 2015-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-02-01 | 0 |
| Total of all active and inactive participants | 2015-02-01 | 36 |
| Measure | Date | Value |
|---|
| 2020 : PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-07-31 | $0 |
| Total plan liabilities at beginning of year | 2020-07-31 | $17,290 |
| Total income from all sources | 2020-07-31 | $60,001 |
| Expenses. Total of all expenses incurred | 2020-07-31 | $152,975 |
| Benefits paid (including direct rollovers) | 2020-07-31 | $87,834 |
| Total plan assets at end of year | 2020-07-31 | $0 |
| Total plan assets at beginning of year | 2020-07-31 | $110,264 |
| Value of fidelity bond covering the plan | 2020-07-31 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2020-07-31 | $63,641 |
| Other income received | 2020-07-31 | $238 |
| Net income (gross income less expenses) | 2020-07-31 | $-92,974 |
| Net plan assets at end of year (total assets less liabilities) | 2020-07-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-07-31 | $92,974 |
| Total contributions received or receivable from employer(s) | 2020-07-31 | $59,763 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-07-31 | $1,500 |
| Total plan liabilities at end of year | 2020-01-31 | $17,290 |
| Total plan liabilities at beginning of year | 2020-01-31 | $16,510 |
| Total income from all sources | 2020-01-31 | $184,402 |
| Expenses. Total of all expenses incurred | 2020-01-31 | $194,813 |
| Total plan assets at end of year | 2020-01-31 | $110,264 |
| Total plan assets at beginning of year | 2020-01-31 | $119,895 |
| Value of fidelity bond covering the plan | 2020-01-31 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2020-01-31 | $191,813 |
| Other income received | 2020-01-31 | $1,896 |
| Net income (gross income less expenses) | 2020-01-31 | $-10,411 |
| Net plan assets at end of year (total assets less liabilities) | 2020-01-31 | $92,974 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-01-31 | $103,385 |
| Total contributions received or receivable from employer(s) | 2020-01-31 | $182,506 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-01-31 | $3,000 |
| 2019 : PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-01-31 | $16,510 |
| Total plan liabilities at beginning of year | 2019-01-31 | $32,177 |
| Total income from all sources | 2019-01-31 | $184,617 |
| Expenses. Total of all expenses incurred | 2019-01-31 | $195,799 |
| Total plan assets at end of year | 2019-01-31 | $119,895 |
| Total plan assets at beginning of year | 2019-01-31 | $146,744 |
| Value of fidelity bond covering the plan | 2019-01-31 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2019-01-31 | $192,799 |
| Other income received | 2019-01-31 | $1,773 |
| Net income (gross income less expenses) | 2019-01-31 | $-11,182 |
| Net plan assets at end of year (total assets less liabilities) | 2019-01-31 | $103,385 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-01-31 | $114,567 |
| Total contributions received or receivable from employer(s) | 2019-01-31 | $182,844 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-01-31 | $3,000 |
| 2018 : PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-01-31 | $32,177 |
| Total plan liabilities at beginning of year | 2018-01-31 | $37,882 |
| Total income from all sources | 2018-01-31 | $184,222 |
| Expenses. Total of all expenses incurred | 2018-01-31 | $195,583 |
| Total plan assets at end of year | 2018-01-31 | $146,744 |
| Total plan assets at beginning of year | 2018-01-31 | $163,810 |
| Value of fidelity bond covering the plan | 2018-01-31 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2018-01-31 | $192,583 |
| Other income received | 2018-01-31 | $496 |
| Net income (gross income less expenses) | 2018-01-31 | $-11,361 |
| Net plan assets at end of year (total assets less liabilities) | 2018-01-31 | $114,567 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-01-31 | $125,928 |
| Total contributions received or receivable from employer(s) | 2018-01-31 | $183,726 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-01-31 | $3,000 |
| 2017 : PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-01-31 | $37,882 |
| Total plan liabilities at beginning of year | 2017-01-31 | $5,647 |
| Total income from all sources | 2017-01-31 | $188,063 |
| Expenses. Total of all expenses incurred | 2017-01-31 | $205,771 |
| Total plan assets at end of year | 2017-01-31 | $163,810 |
| Total plan assets at beginning of year | 2017-01-31 | $149,283 |
| Value of fidelity bond covering the plan | 2017-01-31 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2017-01-31 | $202,771 |
| Other income received | 2017-01-31 | $250 |
| Net income (gross income less expenses) | 2017-01-31 | $-17,708 |
| Net plan assets at end of year (total assets less liabilities) | 2017-01-31 | $125,928 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-01-31 | $143,636 |
| Total contributions received or receivable from employer(s) | 2017-01-31 | $187,813 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-01-31 | $3,000 |
| 2016 : PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2016 401k financial data |
|---|
| Transfers to/from the plan | 2016-01-31 | $149,834 |
| Total plan liabilities at end of year | 2016-01-31 | $5,647 |
| Total plan liabilities at beginning of year | 2016-01-31 | $0 |
| Total income from all sources | 2016-01-31 | $232,578 |
| Expenses. Total of all expenses incurred | 2016-01-31 | $238,776 |
| Total plan assets at end of year | 2016-01-31 | $149,283 |
| Total plan assets at beginning of year | 2016-01-31 | $0 |
| Value of fidelity bond covering the plan | 2016-01-31 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2016-01-31 | $236,026 |
| Other income received | 2016-01-31 | $21 |
| Net income (gross income less expenses) | 2016-01-31 | $-6,198 |
| Net plan assets at end of year (total assets less liabilities) | 2016-01-31 | $143,636 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-01-31 | $0 |
| Total contributions received or receivable from employer(s) | 2016-01-31 | $232,557 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-01-31 | $2,750 |
| 2020: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2020 form 5500 responses |
|---|
| 2020-02-01 | Type of plan entity | Single employer plan |
| 2020-02-01 | Submission has been amended | No |
| 2020-02-01 | This submission is the final filing | Yes |
| 2020-02-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-02-01 | Plan is a collectively bargained plan | No |
| 2020-02-01 | Plan funding arrangement – Insurance | Yes |
| 2020-02-01 | Plan funding arrangement – Trust | Yes |
| 2020-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement - Trust | Yes |
| 2019: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2019 form 5500 responses |
|---|
| 2019-02-01 | Type of plan entity | Single employer plan |
| 2019-02-01 | Submission has been amended | No |
| 2019-02-01 | This submission is the final filing | No |
| 2019-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-02-01 | Plan is a collectively bargained plan | No |
| 2019-02-01 | Plan funding arrangement – Insurance | Yes |
| 2019-02-01 | Plan funding arrangement – Trust | Yes |
| 2019-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement - Trust | Yes |
| 2018: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2018 form 5500 responses |
|---|
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | Submission has been amended | No |
| 2018-02-01 | This submission is the final filing | No |
| 2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-02-01 | Plan is a collectively bargained plan | No |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan funding arrangement – Trust | Yes |
| 2018-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement - Trust | Yes |
| 2017: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2017 form 5500 responses |
|---|
| 2017-02-01 | Type of plan entity | Single employer plan |
| 2017-02-01 | Submission has been amended | No |
| 2017-02-01 | This submission is the final filing | No |
| 2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-02-01 | Plan is a collectively bargained plan | No |
| 2017-02-01 | Plan funding arrangement – Insurance | Yes |
| 2017-02-01 | Plan funding arrangement – Trust | Yes |
| 2017-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement - Trust | Yes |
| 2016: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2016 form 5500 responses |
|---|
| 2016-02-01 | Type of plan entity | Single employer plan |
| 2016-02-01 | Submission has been amended | No |
| 2016-02-01 | This submission is the final filing | No |
| 2016-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-02-01 | Plan is a collectively bargained plan | No |
| 2016-02-01 | Plan funding arrangement – Insurance | Yes |
| 2016-02-01 | Plan funding arrangement – Trust | Yes |
| 2016-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-02-01 | Plan benefit arrangement - Trust | Yes |
| 2015: PROJECT HIRED HEALTH AND WELFARE TRUST PLAN 2015 form 5500 responses |
|---|
| 2015-02-01 | Type of plan entity | Single employer plan |
| 2015-02-01 | First time form 5500 has been submitted | Yes |
| 2015-02-01 | Submission has been amended | No |
| 2015-02-01 | This submission is the final filing | No |
| 2015-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-02-01 | Plan is a collectively bargained plan | No |
| 2015-02-01 | Plan funding arrangement – Insurance | Yes |
| 2015-02-01 | Plan funding arrangement – Trust | Yes |
| 2015-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-02-01 | Plan benefit arrangement - Trust | Yes |
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | TCA0124F |
| Policy instance | 1 |
| Insurance contract or identification number | TCA0124F | | Number of Individuals Covered | 0 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $15,390 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $91,881 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,937 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 30055827 |
| Policy instance | 2 |
| Insurance contract or identification number | 30055827 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $61 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $612 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $61 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | TCA0124F |
| Policy instance | 1 |
| Insurance contract or identification number | TCA0124F | | Number of Individuals Covered | 28 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $31,093 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $185,152 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,119 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 30055827 |
| Policy instance | 2 |
| Insurance contract or identification number | 30055827 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $401 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $4,335 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $401 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | TRUSTIL |
| Policy instance | 1 |
| Insurance contract or identification number | TRUSTIL | | Number of Individuals Covered | 35 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $18,237 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $182,369 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,942 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | THE BOON INSURANCE AGENCY, INC. |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 30055827 |
| Policy instance | 2 |
| Insurance contract or identification number | 30055827 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $384 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,844 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $384 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | BRUCE HARRIS |
|
