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BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameBOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN
Plan identification number 501

BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

BOZEMAN DEACONESS HEALTH SERVICES has sponsored the creation of one or more 401k plans.

Company Name:BOZEMAN DEACONESS HEALTH SERVICES
Employer identification number (EIN):810232121
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01BRAD LUDFORD2019-10-11
5012017-01-01BRAD LUDFORD
5012017-01-01BRAD LUDFORD2021-03-23
5012016-01-01GORDON DAVIDSON
5012016-01-01BRAD LUDFORD2021-03-23
5012015-01-01GORDON DAVIDSON
5012015-01-01BRAD LUDFORD2021-03-23
5012014-01-01GORDON DAVIDSON
5012014-01-01BRAD LUDFORD2021-03-23
5012013-01-01GORDON DAVIDSON
5012013-01-01BRAD LUDFORD2021-03-23
5012012-01-01GORDON DAVIDSON
5012012-01-01
5012011-01-01GORDON DAVIDSON
5012009-01-01GORDON DAVIDSON

Plan Statistics for BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN

401k plan membership statisitcs for BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN

Measure Date Value
2022: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,588
Total number of active participants reported on line 7a of the Form 55002022-01-011,575
Number of retired or separated participants receiving benefits2022-01-0111
Total of all active and inactive participants2022-01-011,586
2021: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,523
Total number of active participants reported on line 7a of the Form 55002021-01-011,581
Number of retired or separated participants receiving benefits2021-01-017
Total of all active and inactive participants2021-01-011,588
2020: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,421
Total number of active participants reported on line 7a of the Form 55002020-01-011,515
Number of retired or separated participants receiving benefits2020-01-018
Total of all active and inactive participants2020-01-011,523
2019: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,405
Total number of active participants reported on line 7a of the Form 55002019-01-011,407
Number of retired or separated participants receiving benefits2019-01-0114
Total of all active and inactive participants2019-01-011,421
2018: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,433
Total number of active participants reported on line 7a of the Form 55002018-01-011,391
Number of retired or separated participants receiving benefits2018-01-0114
Total of all active and inactive participants2018-01-011,405
2017: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,342
Total number of active participants reported on line 7a of the Form 55002017-01-011,406
Number of retired or separated participants receiving benefits2017-01-016
Number of other retired or separated participants entitled to future benefits2017-01-0121
Total of all active and inactive participants2017-01-011,433
2016: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,230
Total number of active participants reported on line 7a of the Form 55002016-01-011,320
Number of retired or separated participants receiving benefits2016-01-015
Number of other retired or separated participants entitled to future benefits2016-01-0117
Total of all active and inactive participants2016-01-011,342
2015: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,333
Total number of active participants reported on line 7a of the Form 55002015-01-011,165
Number of retired or separated participants receiving benefits2015-01-0114
Number of other retired or separated participants entitled to future benefits2015-01-0151
Total of all active and inactive participants2015-01-011,230
2014: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,250
Total number of active participants reported on line 7a of the Form 55002014-01-011,308
Number of retired or separated participants receiving benefits2014-01-018
Number of other retired or separated participants entitled to future benefits2014-01-0117
Total of all active and inactive participants2014-01-011,333
Total participants2014-01-011,333
2013: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,158
Total number of active participants reported on line 7a of the Form 55002013-01-011,250
Total of all active and inactive participants2013-01-011,250
Total participants2013-01-011,250
2012: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,149
Total number of active participants reported on line 7a of the Form 55002012-01-011,158
Total of all active and inactive participants2012-01-011,158
Total participants2012-01-011,158
2011: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,051
Total number of active participants reported on line 7a of the Form 55002011-01-011,149
Total of all active and inactive participants2011-01-011,149
Total participants2011-01-011,149
2009: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,352
Total number of active participants reported on line 7a of the Form 55002009-01-011,482
Total of all active and inactive participants2009-01-011,482
Total participants2009-01-011,482

Financial Data on BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN

Measure Date Value
2022 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$3,531,313
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$5,931,094
Total income from all sources (including contributions)2022-12-31$29,704,237
Total of all expenses incurred2022-12-31$29,860,088
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$28,941,078
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$29,691,244
Value of total assets at end of year2022-12-31$1,665,562
Value of total assets at beginning of year2022-12-31$4,221,194
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$919,010
Total interest from all sources2022-12-31$12,993
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$25,434
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$6,044,457
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$332,029
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$262,373
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$1,074,993
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$4,001,724
Total non interest bearing cash at end of year2022-12-31$50,000
Total non interest bearing cash at beginning of year2022-12-31$17,729
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-155,851
Value of net assets at end of year (total assets less liabilities)2022-12-31$-1,865,751
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$-1,709,900
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$1,326,194
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$2,352,060
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$2,352,060
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$12,993
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$3,920,285
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$23,384,414
Employer contributions (assets) at end of year2022-12-31$289,368
Employer contributions (assets) at beginning of year2022-12-31$1,519,376
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$25,020,793
Contract administrator fees2022-12-31$893,576
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Liabilities. Value of benefit claims payable at end of year2022-12-31$2,456,320
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$1,929,370
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31EIDE BAILLY LLP
Accountancy firm EIN2022-12-31450250958
2021 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$5,931,094
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$8,809,525
Total income from all sources (including contributions)2021-12-31$22,437,576
Total of all expenses incurred2021-12-31$20,279,638
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$19,333,381
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$22,433,282
Value of total assets at end of year2021-12-31$4,221,194
Value of total assets at beginning of year2021-12-31$4,941,687
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$946,257
Total interest from all sources2021-12-31$4,294
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$38,403
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$5,510,305
Participant contributions at end of year2021-12-31$332,029
Participant contributions at beginning of year2021-12-31$321,548
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$105,729
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$4,001,724
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$356,525
Total non interest bearing cash at end of year2021-12-31$17,729
Total non interest bearing cash at beginning of year2021-12-31$50,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$2,157,938
Value of net assets at end of year (total assets less liabilities)2021-12-31$-1,709,900
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$-3,867,838
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$2,352,060
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$3,243,328
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$3,243,328
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$4,294
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$3,972,762
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$16,817,248
Employer contributions (assets) at end of year2021-12-31$1,519,376
Employer contributions (assets) at beginning of year2021-12-31$1,326,811
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$15,360,619
Contract administrator fees2021-12-31$907,854
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Liabilities. Value of benefit claims payable at end of year2021-12-31$1,929,370
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$8,453,000
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31EIDE BAILLY LLP
Accountancy firm EIN2021-12-31450250958
2020 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$8,809,525
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$3,154,632
Total income from all sources (including contributions)2020-12-31$18,727,236
Total of all expenses incurred2020-12-31$27,353,564
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$26,379,829
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$18,710,550
Value of total assets at end of year2020-12-31$4,941,687
Value of total assets at beginning of year2020-12-31$7,913,122
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$973,735
Total interest from all sources2020-12-31$16,686
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$85,610
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$5,263,725
Participant contributions at end of year2020-12-31$321,548
Participant contributions at beginning of year2020-12-31$283,637
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$59,515
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$40,590
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$356,525
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$958,632
Total non interest bearing cash at end of year2020-12-31$50,000
Total non interest bearing cash at beginning of year2020-12-31$50,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-8,626,328
Value of net assets at end of year (total assets less liabilities)2020-12-31$-3,867,838
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$4,758,490
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$3,243,328
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$6,306,018
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$6,306,018
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$16,686
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$3,396,890
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$13,387,310
Employer contributions (assets) at end of year2020-12-31$1,326,811
Employer contributions (assets) at beginning of year2020-12-31$1,232,877
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$22,982,939
Contract administrator fees2020-12-31$888,125
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Liabilities. Value of benefit claims payable at end of year2020-12-31$8,453,000
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$2,196,000
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31EIDE BAILLY LLP
Accountancy firm EIN2020-12-31450250958
2019 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,154,632
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,555,809
Total income from all sources (including contributions)2019-12-31$19,477,340
Total of all expenses incurred2019-12-31$22,105,634
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$21,247,925
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$19,418,197
Value of total assets at end of year2019-12-31$7,913,122
Value of total assets at beginning of year2019-12-31$8,942,593
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$857,709
Total interest from all sources2019-12-31$59,143
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$41,230
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$4,717,376
Participant contributions at end of year2019-12-31$283,637
Participant contributions at beginning of year2019-12-31$272,728
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$106,145
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$40,590
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$69,919
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$958,632
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$684,809
Total non interest bearing cash at end of year2019-12-31$50,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-2,628,294
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,758,490
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$7,386,784
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$6,306,018
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$7,391,187
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$7,391,187
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$59,143
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$3,065,768
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$14,594,676
Employer contributions (assets) at end of year2019-12-31$1,232,877
Employer contributions (assets) at beginning of year2019-12-31$1,208,759
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$18,182,157
Contract administrator fees2019-12-31$816,479
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Liabilities. Value of benefit claims payable at end of year2019-12-31$2,196,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$871,000
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31EIDE BAILLY LLP
Accountancy firm EIN2019-12-31450250958
2018 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$1,555,809
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,159,632
Total income from all sources (including contributions)2018-12-31$19,832,668
Total of all expenses incurred2018-12-31$18,705,792
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$17,885,606
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$19,739,194
Value of total assets at end of year2018-12-31$8,942,593
Value of total assets at beginning of year2018-12-31$8,419,540
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$820,186
Total interest from all sources2018-12-31$93,474
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$79,665
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$4,777,428
Participant contributions at end of year2018-12-31$272,728
Participant contributions at beginning of year2018-12-31$286,418
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$8,366
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$69,919
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$27,287
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$684,809
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$511,632
Total non interest bearing cash at beginning of year2018-12-31$50,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$1,126,876
Value of net assets at end of year (total assets less liabilities)2018-12-31$7,386,784
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$6,259,908
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$7,391,187
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$6,903,859
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$6,903,859
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$93,474
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$2,692,707
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$14,953,400
Employer contributions (assets) at end of year2018-12-31$1,208,759
Employer contributions (assets) at beginning of year2018-12-31$1,151,976
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$15,192,899
Contract administrator fees2018-12-31$740,521
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Liabilities. Value of benefit claims payable at end of year2018-12-31$871,000
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$1,648,000
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31EIDE BAILLY LLP
Accountancy firm EIN2018-12-31450250958
2017 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$2,159,632
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$2,141,406
Total income from all sources (including contributions)2017-12-31$18,468,544
Total of all expenses incurred2017-12-31$16,756,442
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$16,116,842
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$18,415,394
Value of total assets at end of year2017-12-31$7,335,946
Value of total assets at beginning of year2017-12-31$5,605,618
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$639,600
Total interest from all sources2017-12-31$53,150
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$101,634
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
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
Contributions received from participants2017-12-31$4,690,166
Participant contributions at end of year2017-12-31$286,418
Participant contributions at beginning of year2017-12-31$809,571
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$10,039
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$27,287
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$90,993
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$511,632
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$557,406
Total non interest bearing cash at end of year2017-12-31$50,000
Total non interest bearing cash at beginning of year2017-12-31$910,219
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
Value of net income/loss2017-12-31$1,712,102
Value of net assets at end of year (total assets less liabilities)2017-12-31$5,176,314
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$3,464,212
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$5,820,265
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$1,510,740
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$1,510,740
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$53,150
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$2,606,936
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
Contributions received in cash from employer2017-12-31$13,715,189
Employer contributions (assets) at end of year2017-12-31$1,151,976
Employer contributions (assets) at beginning of year2017-12-31$3,194,314
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$13,509,906
Contract administrator fees2017-12-31$537,966
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
Liabilities. Value of benefit claims payable at end of year2017-12-31$1,648,000
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$1,584,000
Did the plan have assets held for investment2017-12-31Yes
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31EIDE BAILLY LLP
Accountancy firm EIN2017-12-31450250958
2016 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$2,141,406
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,512,333
Total income from all sources (including contributions)2016-12-31$16,914,096
Total of all expenses incurred2016-12-31$15,770,397
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$14,443,631
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$16,889,816
Value of total assets at end of year2016-12-31$5,605,618
Value of total assets at beginning of year2016-12-31$3,832,846
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,326,766
Total interest from all sources2016-12-31$5,765
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$45,428
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$4,270,384
Participant contributions at end of year2016-12-31$809,571
Participant contributions at beginning of year2016-12-31$247,074
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$10,039
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$90,993
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$557,406
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$600,333
Other income not declared elsewhere2016-12-31$18,515
Administrative expenses (other) incurred2016-12-31$53,598
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$5,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,143,699
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,464,212
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,320,513
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$1,510,740
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$2,621,994
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$2,621,994
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$5,765
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$2,194,912
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$12,609,393
Employer contributions (assets) at end of year2016-12-31$3,194,314
Employer contributions (assets) at beginning of year2016-12-31$958,778
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$12,248,719
Contract administrator fees2016-12-31$1,227,740
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$1,584,000
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$912,000
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31EIDE BAILLY LLP
Accountancy firm EIN2016-12-31450250958
2015 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$1,512,333
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$173,375
Total income from all sources (including contributions)2015-12-31$14,684,178
Total of all expenses incurred2015-12-31$12,363,665
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$11,007,548
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$14,680,910
Value of total assets at end of year2015-12-31$3,832,846
Value of total assets at beginning of year2015-12-31$736,844
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,356,117
Total interest from all sources2015-12-31$3,268
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$37,784
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$3,749,045
Participant contributions at end of year2015-12-31$247,074
Participant contributions at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$10,039
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$600,333
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$173,375
Administrative expenses (other) incurred2015-12-31$75,900
Total non interest bearing cash at end of year2015-12-31$5,000
Total non interest bearing cash at beginning of year2015-12-31$736,844
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$2,320,513
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,320,513
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$563,469
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$2,621,994
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$3,268
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$1,743,141
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$10,921,826
Employer contributions (assets) at end of year2015-12-31$958,778
Employer contributions (assets) at beginning of year2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$9,264,407
Contract administrator fees2015-12-31$1,242,433
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$912,000
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$0
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31EIDE BAILLY LLP
Accountancy firm EIN2015-12-31450250958
2014 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$173,375
Total income from all sources (including contributions)2014-12-31$13,001,445
Total of all expenses incurred2014-12-31$12,828,070
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$12,828,070
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$13,001,445
Value of total assets at end of year2014-12-31$736,844
Value of total assets at beginning of year2014-12-31$390,094
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$3,187,073
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$173,375
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$173,375
Total non interest bearing cash at end of year2014-12-31$736,844
Total non interest bearing cash at beginning of year2014-12-31$390,094
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$173,375
Value of net assets at end of year (total assets less liabilities)2014-12-31$563,469
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$390,094
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$12,828,070
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$9,640,997
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31EIDE BAILLY LLP
Accountancy firm EIN2014-12-31450250958
2013 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-12-31$10,634,852
Total of all expenses incurred2013-12-31$10,461,477
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$10,461,477
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$10,634,852
Value of total assets at end of year2013-12-31$390,094
Value of total assets at beginning of year2013-12-31$216,719
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$2,744,657
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$173,375
Total non interest bearing cash at end of year2013-12-31$390,094
Total non interest bearing cash at beginning of year2013-12-31$216,719
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$173,375
Value of net assets at end of year (total assets less liabilities)2013-12-31$390,094
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$216,719
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$10,461,477
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$7,716,820
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31EIDE BAILLY LLP
Accountancy firm EIN2013-12-31450250958
2012 : BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$9,495,817
Total of all expenses incurred2012-12-31$9,279,098
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$9,279,098
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$9,495,817
Value of total assets at end of year2012-12-31$216,719
Value of total assets at beginning of year2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$2,510,434
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$216,719
Total non interest bearing cash at end of year2012-12-31$216,719
Total non interest bearing cash at beginning of year2012-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$216,719
Value of net assets at end of year (total assets less liabilities)2012-12-31$216,719
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$9,279,098
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$6,768,664
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31EIDE BAILLY LLP
Accountancy firm EIN2012-12-31450250958

Form 5500 Responses for BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN

2022: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: BOZEMAN DEACONESS HEALTH SERVICES COMPREHENSIVE HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908404
Policy instance 4
Insurance contract or identification number908404
Number of Individuals Covered417
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $61,701
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $290,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees61701
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30052931
Policy instance 3
Insurance contract or identification number30052931
Number of Individuals Covered1170
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,223
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $197,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,224
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered2701
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $44,600
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $891,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,600
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered3189
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $55,980
Health Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $1,982,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees55980
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908403
Policy instance 5
Insurance contract or identification number908403
Number of Individuals Covered1868
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $45,507
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $616,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees45507
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered2674
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $41,771
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $806,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,217
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered3349
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $2,056,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30052931
Policy instance 3
Insurance contract or identification number30052931
Number of Individuals Covered1158
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,041
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $187,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,925
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908404
Policy instance 4
Insurance contract or identification number908404
Number of Individuals Covered463
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $45,270
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $213,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees29063
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908403
Policy instance 5
Insurance contract or identification number908403
Number of Individuals Covered1902
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $33,859
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $441,881
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees19499
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered3224
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $1,732,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered2556
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $39,733
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $794,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,733
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30052931
Policy instance 3
Insurance contract or identification number30052931
Number of Individuals Covered1099
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,047
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $177,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,047
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908404
Policy instance 4
Insurance contract or identification number908404
Number of Individuals Covered544
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $38,636
Total amount of fees paid to insurance companyUSD $5,151
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $257,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,636
Amount paid for insurance broker fees5151
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908403
Policy instance 5
Insurance contract or identification number908403
Number of Individuals Covered1794
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $35,213
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $476,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,213
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908403
Policy instance 5
Insurance contract or identification number908403
Number of Individuals Covered1694
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $26,880
Total amount of fees paid to insurance companyUSD $8,975
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $512,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,880
Amount paid for insurance broker fees8975
Additional information about fees paid to insurance brokerINSURANCE FEES
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered2932
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $1,441,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered2296
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $37,144
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $742,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,144
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30052931
Policy instance 3
Insurance contract or identification number30052931
Number of Individuals Covered998
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,135
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $165,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,135
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908404
Policy instance 4
Insurance contract or identification number908404
Number of Individuals Covered528
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $41,951
Total amount of fees paid to insurance companyUSD $4,894
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $279,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,951
Amount paid for insurance broker fees4894
Additional information about fees paid to insurance brokerINSURANCE FEES
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered2814
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $1,190,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered2207
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $35,188
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $703,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,188
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30052931
Policy instance 3
Insurance contract or identification number30052931
Number of Individuals Covered937
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,322
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $150,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,322
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908404
Policy instance 4
Insurance contract or identification number908404
Number of Individuals Covered570
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $24,745
Total amount of fees paid to insurance companyUSD $2,266
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $164,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,745
Amount paid for insurance broker fees2266
Additional information about fees paid to insurance brokerINSURANCE FEES
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908403
Policy instance 5
Insurance contract or identification number908403
Number of Individuals Covered1752
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,849
Total amount of fees paid to insurance companyUSD $4,384
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $261,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,849
Amount paid for insurance broker fees4384
Additional information about fees paid to insurance brokerINSURANCE FEES
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered2077
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $33,414
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $668,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,898
Insurance broker organization code?3
Insurance broker namePAYNEWEST INSURANCE INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908403
Policy instance 5
Insurance contract or identification number908403
Number of Individuals Covered1742
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $19,019
Total amount of fees paid to insurance companyUSD $5,330
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $367,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,466
Amount paid for insurance broker fees3769
Additional information about fees paid to insurance brokerINSURANCE FEES
Insurance broker organization code?3
Insurance broker nameTHE PARTNERS GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908404
Policy instance 4
Insurance contract or identification number908404
Number of Individuals Covered534
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $29,416
Total amount of fees paid to insurance companyUSD $3,000
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $191,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,895
Amount paid for insurance broker fees2123
Additional information about fees paid to insurance brokerINSURANCE FEES
Insurance broker organization code?3
Insurance broker nameTHE PARTNERS GROUP
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30052931
Policy instance 3
Insurance contract or identification number30052931
Number of Individuals Covered894
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,013
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $141,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,149
Insurance broker organization code?3
Insurance broker nameTHE PARTNERS GROUP
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered2822
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $1,170,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908403
Policy instance 5
Insurance contract or identification number908403
Number of Individuals Covered1659
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $23,127
Total amount of fees paid to insurance companyUSD $15,429
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $308,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,127
Amount paid for insurance broker fees15429
Additional information about fees paid to insurance brokerINSURANCE FEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30052931
Policy instance 3
Insurance contract or identification number30052931
Number of Individuals Covered799
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $2,816
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $115,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,816
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered1777
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $30,302
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $606,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,302
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered2613
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $944,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number908404
Policy instance 4
Insurance contract or identification number908404
Number of Individuals Covered491
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $30,617
Total amount of fees paid to insurance companyUSD $8,685
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $173,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,617
Amount paid for insurance broker fees8685
Additional information about fees paid to insurance brokerINSURANCE FEES
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010143353
Policy instance 6
Insurance contract or identification number000010143353
Number of Individuals Covered1184
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $9,048
Total amount of fees paid to insurance companyUSD $3,811
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $180,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,939
Amount paid for insurance broker fees3811
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker namePAYNEWEST INSURANCE INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered2292
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $796,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered1712
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $22,233
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $444,655
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,627
Insurance broker organization code?3
Insurance broker namePAYNEWEST INSURANCE INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30052931
Policy instance 3
Insurance contract or identification number30052931
Number of Individuals Covered682
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,537
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,944
Insurance broker organization code?3
Insurance broker namePAYNEWEST INSURANCE INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000403001354
Policy instance 4
Insurance contract or identification number000403001354
Number of Individuals Covered187
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,096
Total amount of fees paid to insurance companyUSD $226
Life Insurance Welfare BenefitYes
Other welfare benefits providedDEPENDENT LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $12,178
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $723
Amount paid for insurance broker fees226
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker namePAYNEWEST INSURANCE INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010143352
Policy instance 5
Insurance contract or identification number000010143352
Number of Individuals Covered1469
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $19,127
Total amount of fees paid to insurance companyUSD $3,938
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $212,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,450
Amount paid for insurance broker fees3938
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker namePAYNEWEST INSURANCE INC
MHN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number1076
Policy instance 3
Insurance contract or identification number1076
Number of Individuals Covered986
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $87,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10143352
Policy instance 4
Insurance contract or identification number10143352
Number of Individuals Covered1308
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $27,991
Total amount of fees paid to insurance companyUSD $15,201
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 CarrierUSD $395,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,909
Amount paid for insurance broker fees7627
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered2016
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $12,032,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number6182
Policy instance 2
Insurance contract or identification number6182
Number of Individuals Covered1376
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $15,124
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $365,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $15,124
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered1376
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $15,124
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $365,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,124
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30052931
Policy instance 3
Insurance contract or identification number30052931
Number of Individuals Covered986
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number1076-1357
Policy instance 4
Insurance contract or identification number1076-1357
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $16,716
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $83,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $16,716
Insurance broker namePEAK1 ADMINISTRATION
BLUE CROSS BLUE SHIELD OF MONTANA (National Association of Insurance Commissioners NAIC id number: 53686 )
Policy contract numberX6A262
Policy instance 3
Insurance contract or identification numberX6A262
Number of Individuals Covered1810
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $9,650,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered1146
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $15,555
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $298,987
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $15,555
Insurance broker organization code?3
Total amount of fees paid to insurance companyUSD $0
Insurance broker nameLOCKTON COMPANIES, LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10143352
Policy instance 1
Insurance contract or identification number10143352
Number of Individuals Covered1250
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $35,203
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT (THIS SCH A INCLUDES CONTRACTS 10143352, 10143353, & 403001354)
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 CarrierUSD $338,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,722
Insurance broker organization code?3
Amount paid for insurance broker fees10481
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameLOCKTON COMPANIES, LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10143352
Policy instance 4
Insurance contract or identification number10143352
Number of Individuals Covered1250
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $24,722
Total amount of fees paid to insurance companyUSD $10,481
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $338,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,722
Insurance broker organization code?3
Amount paid for insurance broker fees10481
Additional information about fees paid to insurance brokerBROKER BONUS
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number1076-1357
Policy instance 3
Insurance contract or identification number1076-1357
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $16,716
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,716
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MONTANA (National Association of Insurance Commissioners NAIC id number: 53686 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered1810
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,650,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MONTANA (National Association of Insurance Commissioners NAIC id number: 53686 )
Policy contract numberX6A262
Policy instance 3
Insurance contract or identification numberX6A262
Number of Individuals Covered1732
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,865,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered1042
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $14,766
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $295,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $14,766
Insurance broker organization code?3
Total amount of fees paid to insurance companyUSD $0
Insurance broker nameLOCKTON COMPANIES, LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12193879
Policy instance 3
Insurance contract or identification number12193879
Number of Individuals Covered952
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $7,596
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,596
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10143352
Policy instance 1
Insurance contract or identification number10143352
Number of Individuals Covered1158
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $29,872
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT (THIS SCH A INCLUDES CONTRACTS 403001354, 10143352, & 10143353)
Welfare Benefit Premiums Paid to CarrierUSD $349,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,343
Insurance broker organization code?3
Amount paid for insurance broker fees4529
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CROSS BLUE SHIELD OF MONTANA (National Association of Insurance Commissioners NAIC id number: 53686 )
Policy contract numberX6A262
Policy instance 1
Insurance contract or identification numberX6A262
Number of Individuals Covered1732
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,865,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10143352
Policy instance 4
Insurance contract or identification number10143352
Number of Individuals Covered1158
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $25,343
Total amount of fees paid to insurance companyUSD $4,529
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $349,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,343
Insurance broker organization code?3
Amount paid for insurance broker fees4529
Additional information about fees paid to insurance brokerBROKER BONUS
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number06182
Policy instance 2
Insurance contract or identification number06182
Number of Individuals Covered1091
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $14,222
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $284,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number65812-0
Policy instance 4
Insurance contract or identification number65812-0
Number of Individuals Covered1116
Insurance policy start date2011-01-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $10,658
Total amount of fees paid to insurance companyUSD $7,164
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $204,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10143352
Policy instance 3
Insurance contract or identification number10143352
Number of Individuals Covered1149
Insurance policy start date2011-07-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $10,028
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT (THIS SCH A INCLUDES CONTRACTS 403001354 & 10143353)
Welfare Benefit Premiums Paid to CarrierUSD $139,708
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW WEST HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 95829 )
Policy contract numberN001118
Policy instance 1
Insurance contract or identification numberN001118
Number of Individuals Covered1738
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,049,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW WEST HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 95829 )
Policy contract numberN001118
Policy instance 2
Insurance contract or identification numberN001118
Number of Individuals Covered1689
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,334,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number65812-0
Policy instance 1
Insurance contract or identification number65812-0
Number of Individuals Covered1051
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $18,617
Total amount of fees paid to insurance companyUSD $12,632
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $360,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,617
Amount paid for insurance broker fees12632
Additional information about fees paid to insurance brokerOVERWRITE FEES
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMT6182
Policy instance 3
Insurance contract or identification numberMT6182
Number of Individuals Covered1573
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $12,962
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $259,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,962
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC

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