EVEREST GROUP HOLDINGS LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EVEREST GROUP HOLDINGS, LLC HEALTH & WELFARE PLAN
401k plan membership statisitcs for EVEREST GROUP HOLDINGS, LLC HEALTH & WELFARE PLAN
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289903 |
Policy instance | 13 |
Insurance contract or identification number | 289903 | Number of Individuals Covered | 0 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $66 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,201 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $66 | Insurance broker organization code? | 3 |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3351 |
Policy instance | 1 |
Insurance contract or identification number | 3351 | Number of Individuals Covered | 108 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $531 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $531 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289301 |
Policy instance | 2 |
Insurance contract or identification number | 289301 | Number of Individuals Covered | 4 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $1,699 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $69,094 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,699 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289303 |
Policy instance | 3 |
Insurance contract or identification number | 289303 | Number of Individuals Covered | 3 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $759 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,987 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $759 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289304 |
Policy instance | 4 |
Insurance contract or identification number | 289304 | Number of Individuals Covered | 8 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $1,782 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $78,287 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,782 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0BXVB |
Policy instance | 5 |
Insurance contract or identification number | GLTD0BXVB | Number of Individuals Covered | 238 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $3,865 | Total amount of fees paid to insurance company | USD $3,028 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,691 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,865 | Amount paid for insurance broker fees | 2019 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BXVB |
Policy instance | 6 |
Insurance contract or identification number | GLUG0BXVB | Number of Individuals Covered | 238 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $3,559 | Total amount of fees paid to insurance company | USD $5,759 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $41,189 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,559 | Amount paid for insurance broker fees | 2467 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG 0BXVB |
Policy instance | 7 |
Insurance contract or identification number | GUG 0BXVB | Number of Individuals Covered | 238 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $3,551 | Total amount of fees paid to insurance company | USD $5,750 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,024 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,551 | Amount paid for insurance broker fees | 2466 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0BXVB |
Policy instance | 8 |
Insurance contract or identification number | GVTL0BXVB | Number of Individuals Covered | 70 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $2,561 | Total amount of fees paid to insurance company | USD $3,657 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $25,605 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,561 | Amount paid for insurance broker fees | 1585 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUDS0BXVB |
Policy instance | 9 |
Insurance contract or identification number | GUDS0BXVB | Number of Individuals Covered | 148 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $2,805 | Total amount of fees paid to insurance company | USD $6,576 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $64,565 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,805 | Amount paid for insurance broker fees | 2009 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289305 |
Policy instance | 10 |
Insurance contract or identification number | 289305 | Number of Individuals Covered | 49 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $10,049 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $466,079 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,049 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289803 |
Policy instance | 11 |
Insurance contract or identification number | 289803 | Number of Individuals Covered | 38 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $7,584 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $385,726 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,584 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289804 |
Policy instance | 12 |
Insurance contract or identification number | 289804 | Number of Individuals Covered | 54 | Insurance policy start date | 2022-08-01 | Insurance policy end date | 2023-07-31 | Total amount of commissions paid to insurance broker | USD $7,679 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $369,254 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,679 | Insurance broker organization code? | 3 |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3351 |
Policy instance | 1 |
Insurance contract or identification number | 3351 | Number of Individuals Covered | 115 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $280 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $280 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289301 |
Policy instance | 2 |
Insurance contract or identification number | 289301 | Number of Individuals Covered | 9 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $2,637 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $93,882 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,637 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289302 |
Policy instance | 3 |
Insurance contract or identification number | 289302 | Number of Individuals Covered | 63 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $11,569 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $388,554 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,569 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289303 |
Policy instance | 4 |
Insurance contract or identification number | 289303 | Number of Individuals Covered | 3 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $739 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,803 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $739 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289802 |
Policy instance | 6 |
Insurance contract or identification number | 289802 | Number of Individuals Covered | 51 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $7,474 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $249,724 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,474 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289304 |
Policy instance | 7 |
Insurance contract or identification number | 289304 | Number of Individuals Covered | 3 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $517 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,193 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $517 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289901 |
Policy instance | 8 |
Insurance contract or identification number | 289901 | Number of Individuals Covered | 1 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $399 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,516 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $399 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUDS0BXVB |
Policy instance | 13 |
Insurance contract or identification number | GUDS0BXVB | Number of Individuals Covered | 151 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $2,899 | Total amount of fees paid to insurance company | USD $850 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $69,954 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,899 | Amount paid for insurance broker fees | 541 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0BXVB |
Policy instance | 12 |
Insurance contract or identification number | GVTL0BXVB | Number of Individuals Covered | 71 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $2,707 | Total amount of fees paid to insurance company | USD $905 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $27,071 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,707 | Amount paid for insurance broker fees | 487 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG 0BXVB |
Policy instance | 11 |
Insurance contract or identification number | GUG 0BXVB | Number of Individuals Covered | 257 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $3,491 | Total amount of fees paid to insurance company | USD $1,164 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $39,823 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,491 | Amount paid for insurance broker fees | 627 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BXVB |
Policy instance | 10 |
Insurance contract or identification number | GLUG0BXVB | Number of Individuals Covered | 257 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $3,474 | Total amount of fees paid to insurance company | USD $1,103 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $39,471 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,474 | Amount paid for insurance broker fees | 594 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0BXVB |
Policy instance | 9 |
Insurance contract or identification number | GLTD0BXVB | Number of Individuals Covered | 257 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $3,620 | Total amount of fees paid to insurance company | USD $919 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,405 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,620 | Amount paid for insurance broker fees | 495 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289800 |
Policy instance | 5 |
Insurance contract or identification number | 289800 | Number of Individuals Covered | 35 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $8,966 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $298,549 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,966 | Insurance broker organization code? | 3 |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3351 |
Policy instance | 1 |
Insurance contract or identification number | 3351 | Number of Individuals Covered | 125 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $575 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $575 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5711584 |
Policy instance | 2 |
Insurance contract or identification number | 5711584 | Number of Individuals Covered | 319 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $13,413 | Total amount of fees paid to insurance company | USD $551 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $216,932 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,413 | Amount paid for insurance broker fees | 551 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289301 |
Policy instance | 3 |
Insurance contract or identification number | 289301 | Number of Individuals Covered | 3 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $1,016 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,087 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,016 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289302 |
Policy instance | 4 |
Insurance contract or identification number | 289302 | Number of Individuals Covered | 62 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $9,332 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $316,214 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,332 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289303 |
Policy instance | 5 |
Insurance contract or identification number | 289303 | Number of Individuals Covered | 4 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $531 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,828 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $531 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289800 |
Policy instance | 6 |
Insurance contract or identification number | 289800 | Number of Individuals Covered | 45 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $9,221 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $309,909 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,221 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289802 |
Policy instance | 7 |
Insurance contract or identification number | 289802 | Number of Individuals Covered | 73 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $7,407 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $253,095 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,407 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289304 |
Policy instance | 8 |
Insurance contract or identification number | 289304 | Number of Individuals Covered | 1 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $50 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,067 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $50 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289901 |
Policy instance | 9 |
Insurance contract or identification number | 289901 | Number of Individuals Covered | 2 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $55 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,310 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $55 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5711584 |
Policy instance | 2 |
Insurance contract or identification number | 5711584 | Number of Individuals Covered | 325 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $13,786 | Total amount of fees paid to insurance company | USD $283 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $223,320 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,786 | Amount paid for insurance broker fees | 283 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5711584 |
Policy instance | 3 |
Insurance contract or identification number | 5711584 | Number of Individuals Covered | 326 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $2,993 | Total amount of fees paid to insurance company | USD $272 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $50,425 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,993 | Amount paid for insurance broker fees | 272 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289301 |
Policy instance | 4 |
Insurance contract or identification number | 289301 | Number of Individuals Covered | 7 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $2,810 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $63,917 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,722 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289302 |
Policy instance | 5 |
Insurance contract or identification number | 289302 | Number of Individuals Covered | 57 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $14,959 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $346,020 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,903 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289303 |
Policy instance | 6 |
Insurance contract or identification number | 289303 | Number of Individuals Covered | 1 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $264 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,354 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $176 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289800 |
Policy instance | 7 |
Insurance contract or identification number | 289800 | Number of Individuals Covered | 50 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $15,079 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $349,618 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,057 | Insurance broker organization code? | 3 |
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UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 289802 |
Policy instance | 8 |
Insurance contract or identification number | 289802 | Number of Individuals Covered | 58 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $9,696 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $220,572 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,566 | Insurance broker organization code? | 3 |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3351 |
Policy instance | 1 |
Insurance contract or identification number | 3351 | Number of Individuals Covered | 119 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $316 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $316 | Insurance broker organization code? | 3 |
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