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AGFINITY INC EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameAGFINITY INC EMPLOYEE BENEFIT PLAN
Plan identification number 501

AGFINITY INC EMPLOYEE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

AGFINITY INC has sponsored the creation of one or more 401k plans.

Company Name:AGFINITY INC
Employer identification number (EIN):840294550
NAIC Classification:453990

Additional information about AGFINITY INC

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 2005-08-18
Company Identification Number: 20051315266
Legal Registered Office Address: 260 Factory Road
Post Office Box 338
Eaton
United States of America (USA)
80615

More information about AGFINITY INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AGFINITY INC EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01HARRIET WHITE2023-05-05
5012021-01-01JEREMY HENKELS2022-07-11
5012020-01-01JEREMY J. HENKELS2021-07-21
5012019-01-01JEREMY HENKELS2020-05-11
5012018-01-01JEREMY J. HENKELS2019-09-27
5012018-01-01
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-05-01
5012012-05-01ROB LYONS
5012011-05-01ROB LYONS
5012009-05-01ROB LYONS

Plan Statistics for AGFINITY INC EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for AGFINITY INC EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: AGFINITY INC EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01171
Total number of active participants reported on line 7a of the Form 55002022-01-01167
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01167
Number of employers contributing to the scheme2022-01-010
2021: AGFINITY INC EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01188
Total number of active participants reported on line 7a of the Form 55002021-01-01178
Number of retired or separated participants receiving benefits2021-01-013
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01181
Number of employers contributing to the scheme2021-01-010
2020: AGFINITY INC EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01190
Total number of active participants reported on line 7a of the Form 55002020-01-01181
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01181
Number of employers contributing to the scheme2020-01-010
2019: AGFINITY INC EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01108
Total number of active participants reported on line 7a of the Form 55002019-01-01214
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01214
Number of employers contributing to the scheme2019-01-010
2018: AGFINITY INC EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01125
Total number of active participants reported on line 7a of the Form 55002018-01-01108
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01108
Number of employers contributing to the scheme2018-01-010
2017: AGFINITY INC EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01203
Total number of active participants reported on line 7a of the Form 55002017-01-01255
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01255
2016: AGFINITY INC EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01183
Total number of active participants reported on line 7a of the Form 55002016-01-01200
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01203
2015: AGFINITY INC EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01189
Number of retired or separated participants receiving benefits2015-01-01183
Total of all active and inactive participants2015-01-01183
2014: AGFINITY INC EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01173
Total number of active participants reported on line 7a of the Form 55002014-01-01189
Total of all active and inactive participants2014-01-01189
2013: AGFINITY INC EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01178
Total number of active participants reported on line 7a of the Form 55002013-05-01173
Total of all active and inactive participants2013-05-01173
2012: AGFINITY INC EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01129
Total number of active participants reported on line 7a of the Form 55002012-05-01178
Total of all active and inactive participants2012-05-01178
2011: AGFINITY INC EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01123
Total number of active participants reported on line 7a of the Form 55002011-05-01129
Total of all active and inactive participants2011-05-01129
2009: AGFINITY INC EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01124
Total number of active participants reported on line 7a of the Form 55002009-05-01117
Total of all active and inactive participants2009-05-01117

Financial Data on AGFINITY INC EMPLOYEE BENEFIT PLAN

Measure Date Value
2018 : AGFINITY INC EMPLOYEE BENEFIT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,385,648
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,475,226
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,440,226
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,385,648
Value of total assets at end of year2018-12-31$0
Value of total assets at beginning of year2018-12-31$89,578
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$35,000
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
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$560,920
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$33,941
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$89,578
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-89,578
Value of net assets at end of year (total assets less liabilities)2018-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$89,578
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
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$1,440,226
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$790,787
Contract administrator fees2018-12-31$35,000
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$0
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$0
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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 name2018-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2018-12-31410746749
2017 : AGFINITY INC EMPLOYEE BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$229,589
Total income from all sources (including contributions)2017-12-31$1,697,126
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$1,531,826
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,456,373
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,697,126
Value of total assets at end of year2017-12-31$89,578
Value of total assets at beginning of year2017-12-31$153,867
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$75,453
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
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$607,847
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$36,700
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$153,867
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$12,308
Total non interest bearing cash at end of year2017-12-31$89,578
Total non interest bearing cash at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$165,300
Value of net assets at end of year (total assets less liabilities)2017-12-31$89,578
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-75,722
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
Investment advisory and management fees2017-12-31$53,341
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$1,510,691
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$1,052,579
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$-54,318
Contract administrator fees2017-12-31$22,112
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$0
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$217,281
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
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 name2017-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2017-12-31410746749
2016 : AGFINITY INC EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$229,589
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$321,605
Total income from all sources (including contributions)2016-12-31$1,972,875
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$2,036,587
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,929,810
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,972,875
Value of total assets at end of year2016-12-31$153,867
Value of total assets at beginning of year2016-12-31$309,595
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$106,777
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31No
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$397,055
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$47,825
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$153,867
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$276,207
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$12,308
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$0
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$33,388
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-63,712
Value of net assets at end of year (total assets less liabilities)2016-12-31$-75,722
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-12,010
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
Investment advisory and management fees2016-12-31$40,976
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$436,320
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$1,527,995
Employer contributions (assets) at end of year2016-12-31$0
Employer contributions (assets) at beginning of year2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,493,490
Contract administrator fees2016-12-31$65,801
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$217,281
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$321,605
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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 name2016-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2016-12-31410746749
2015 : AGFINITY INC EMPLOYEE BENEFIT PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$321,605
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$1,030,321
Total income from all sources (including contributions)2015-12-31$2,781,114
Total of all expenses incurred2015-12-31$2,005,938
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$1,924,438
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$2,781,112
Value of total assets at end of year2015-12-31$309,595
Value of total assets at beginning of year2015-12-31$243,135
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$81,500
Total interest from all sources2015-12-31$2
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31No
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$730,289
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$31,834
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$276,207
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$143,347
Liabilities. Value of operating payables at beginning of year2015-12-31$518,286
Total non interest bearing cash at end of year2015-12-31$33,388
Total non interest bearing cash at beginning of year2015-12-31$91,402
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$775,176
Value of net assets at end of year (total assets less liabilities)2015-12-31$-12,010
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-787,186
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
Investment advisory and management fees2015-12-31$47,680
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$8,386
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$8,386
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$2
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$351,558
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$2,018,989
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$1,572,880
Contract administrator fees2015-12-31$33,820
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$321,605
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$512,035
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 name2015-12-31SCOFIELD & SCOFIELD PC
Accountancy firm EIN2015-12-31840710782
2014 : AGFINITY INC EMPLOYEE BENEFIT PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$1,030,321
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$248,436
Total income from all sources (including contributions)2014-12-31$1,933,491
Total of all expenses incurred2014-12-31$2,735,181
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$2,666,300
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,933,443
Value of total assets at end of year2014-12-31$243,135
Value of total assets at beginning of year2014-12-31$262,940
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$68,881
Total interest from all sources2014-12-31$48
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 bond2014-12-31No
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$574,375
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$14,236
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$143,347
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$67,479
Liabilities. Value of operating payables at end of year2014-12-31$518,286
Liabilities. Value of operating payables at beginning of year2014-12-31$10,873
Total non interest bearing cash at end of year2014-12-31$91,402
Total non interest bearing cash at beginning of year2014-12-31$86,958
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-801,690
Value of net assets at end of year (total assets less liabilities)2014-12-31$-787,186
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$14,504
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
Investment advisory and management fees2014-12-31$38,521
Interest earned on other investments2014-12-31$29
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$8,386
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$108,503
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$108,503
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$19
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$342,365
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$1,344,832
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$2,323,935
Contract administrator fees2014-12-31$30,360
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
Liabilities. Value of benefit claims payable at end of year2014-12-31$512,035
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$237,563
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31SCOFIELD & SCOFIELD PC
Accountancy firm EIN2014-12-31840710782
2013 : AGFINITY INC EMPLOYEE BENEFIT PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$248,436
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$357,276
Total income from all sources (including contributions)2013-12-31$1,126,124
Total of all expenses incurred2013-12-31$1,089,764
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,046,186
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,117,120
Value of total assets at end of year2013-12-31$262,940
Value of total assets at beginning of year2013-12-31$335,420
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$43,578
Total interest from all sources2013-12-31$9,004
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 bond2013-12-31No
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$329,865
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$16,336
Liabilities. Value of operating payables at end of year2013-12-31$10,873
Total non interest bearing cash at end of year2013-12-31$86,958
Total non interest bearing cash at beginning of year2013-12-31$227,042
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$36,360
Value of net assets at end of year (total assets less liabilities)2013-12-31$14,504
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-21,856
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
Investment advisory and management fees2013-12-31$26,914
Interest earned on other investments2013-12-31$8,879
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$108,503
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$108,378
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$108,378
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$125
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$171,474
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$770,919
Employer contributions (assets) at end of year2013-12-31$67,479
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$874,712
Contract administrator fees2013-12-31$16,664
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$237,563
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$357,276
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31SCOFIELD & SCOFIELD PC
Accountancy firm EIN2013-12-31840710782
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-04-30$357,276
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-04-30$254,421
Total income from all sources (including contributions)2013-04-30$1,332,275
Total of all expenses incurred2013-04-30$1,473,871
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-04-30$1,438,996
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-04-30$1,329,342
Value of total assets at end of year2013-04-30$335,420
Value of total assets at beginning of year2013-04-30$374,161
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-04-30$34,875
Total interest from all sources2013-04-30$2,933
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-04-30No
Was this plan covered by a fidelity bond2013-04-30No
If this is an individual account plan, was there a blackout period2013-04-30No
Were there any nonexempt tranactions with any party-in-interest2013-04-30No
Contributions received from participants2013-04-30$402,204
Total non interest bearing cash at end of year2013-04-30$227,042
Total non interest bearing cash at beginning of year2013-04-30$132,786
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Value of net income/loss2013-04-30$-141,596
Value of net assets at end of year (total assets less liabilities)2013-04-30$-21,856
Value of net assets at beginning of year (total assets less liabilities)2013-04-30$119,740
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-04-30No
Were any leases to which the plan was party in default or uncollectible2013-04-30No
Investment advisory and management fees2013-04-30$8,533
Interest earned on other investments2013-04-30$2,265
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-04-30$108,378
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-04-30$241,375
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-04-30$241,375
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-04-30$668
Expenses. Payments to insurance carriers foe the provision of benefits2013-04-30$269,404
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-04-30No
Was there a failure to transmit to the plan any participant contributions2013-04-30No
Has the plan failed to provide any benefit when due under the plan2013-04-30No
Contributions received in cash from employer2013-04-30$927,138
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-04-30$1,169,592
Contract administrator fees2013-04-30$26,342
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-04-30No
Liabilities. Value of benefit claims payable at end of year2013-04-30$357,276
Liabilities. Value of benefit claims payable at beginning of year2013-04-30$254,421
Did the plan have assets held for investment2013-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-04-30No
Opinion of an independent qualified public accountant for this plan2013-04-30Unqualified
Accountancy firm name2013-04-30SCOFIELD & SCOFIELD PC
Accountancy firm EIN2013-04-30840710782
2012 : AGFINITY INC EMPLOYEE BENEFIT PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-04-30$254,421
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-04-30$369,609
Total income from all sources (including contributions)2012-04-30$1,304,587
Total of all expenses incurred2012-04-30$925,801
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-04-30$894,181
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-04-30$1,295,362
Value of total assets at end of year2012-04-30$374,161
Value of total assets at beginning of year2012-04-30$110,563
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-04-30$31,620
Total interest from all sources2012-04-30$9,225
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-04-30No
Was this plan covered by a fidelity bond2012-04-30No
If this is an individual account plan, was there a blackout period2012-04-30No
Were there any nonexempt tranactions with any party-in-interest2012-04-30No
Contributions received from participants2012-04-30$391,817
Administrative expenses (other) incurred2012-04-30$75
Total non interest bearing cash at end of year2012-04-30$132,786
Total non interest bearing cash at beginning of year2012-04-30$92,713
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Value of net income/loss2012-04-30$378,786
Value of net assets at end of year (total assets less liabilities)2012-04-30$119,740
Value of net assets at beginning of year (total assets less liabilities)2012-04-30$-259,046
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-04-30No
Were any leases to which the plan was party in default or uncollectible2012-04-30No
Investment advisory and management fees2012-04-30$8,476
Interest earned on other investments2012-04-30$8,805
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-04-30$241,375
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-04-30$17,850
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-04-30$17,850
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-04-30$420
Expenses. Payments to insurance carriers foe the provision of benefits2012-04-30$196,460
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-04-30No
Was there a failure to transmit to the plan any participant contributions2012-04-30No
Has the plan failed to provide any benefit when due under the plan2012-04-30No
Contributions received in cash from employer2012-04-30$903,545
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-04-30$697,721
Contract administrator fees2012-04-30$23,069
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-04-30No
Liabilities. Value of benefit claims payable at end of year2012-04-30$254,421
Liabilities. Value of benefit claims payable at beginning of year2012-04-30$369,609
Did the plan have assets held for investment2012-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-04-30No
Opinion of an independent qualified public accountant for this plan2012-04-30Unqualified
Accountancy firm name2012-04-30SCOFIELD AND SCOFIELD, PC
Accountancy firm EIN2012-04-30840710782
2011 : AGFINITY INC EMPLOYEE BENEFIT PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-04-30$369,609
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-04-30$174,739
Total income from all sources (including contributions)2011-04-30$1,193,512
Total of all expenses incurred2011-04-30$1,549,722
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-04-30$1,520,050
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-04-30$1,185,671
Value of total assets at end of year2011-04-30$110,563
Value of total assets at beginning of year2011-04-30$271,903
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-04-30$29,672
Total interest from all sources2011-04-30$7,841
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-04-30No
Was this plan covered by a fidelity bond2011-04-30No
If this is an individual account plan, was there a blackout period2011-04-30No
Were there any nonexempt tranactions with any party-in-interest2011-04-30No
Contributions received from participants2011-04-30$359,522
Administrative expenses (other) incurred2011-04-30$310
Total non interest bearing cash at end of year2011-04-30$92,713
Total non interest bearing cash at beginning of year2011-04-30$65,483
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Value of net income/loss2011-04-30$-356,210
Value of net assets at end of year (total assets less liabilities)2011-04-30$-259,046
Value of net assets at beginning of year (total assets less liabilities)2011-04-30$97,164
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-04-30No
Were any leases to which the plan was party in default or uncollectible2011-04-30No
Investment advisory and management fees2011-04-30$6,336
Interest earned on other investments2011-04-30$6,883
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-04-30$17,850
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-04-30$206,148
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-04-30$206,148
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-04-30$958
Expenses. Payments to insurance carriers foe the provision of benefits2011-04-30$164,663
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-04-30No
Was there a failure to transmit to the plan any participant contributions2011-04-30No
Has the plan failed to provide any benefit when due under the plan2011-04-30No
Contributions received in cash from employer2011-04-30$826,149
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-04-30$1,355,387
Contract administrator fees2011-04-30$23,026
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-04-30No
Liabilities. Value of benefit claims payable at end of year2011-04-30$369,609
Liabilities. Value of benefit claims payable at beginning of year2011-04-30$174,739
Assets. Value of buildings and other operty used in plan operation at end of year2011-04-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-04-30$272
Did the plan have assets held for investment2011-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-04-30No
Opinion of an independent qualified public accountant for this plan2011-04-30Unqualified
Accountancy firm name2011-04-30SCOFIELD AND SCOFIELD PC
Accountancy firm EIN2011-04-30840710782

Form 5500 Responses for AGFINITY INC EMPLOYEE BENEFIT PLAN

2022: AGFINITY INC EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: AGFINITY INC EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: AGFINITY INC EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: AGFINITY INC EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: AGFINITY INC EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
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: AGFINITY INC EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: AGFINITY INC EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: AGFINITY INC EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: AGFINITY INC EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: AGFINITY INC EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2012: AGFINITY INC EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: AGFINITY INC EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes
2009: AGFINITY INC EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Submission has been amendedYes
2009-05-01This submission is the final filingNo
2009-05-01Plan funding arrangement – TrustYes
2009-05-01Plan benefit arrangement – InsuranceYes
2009-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ANKC
Policy instance 6
Insurance contract or identification numberGLUG0ANKC
Number of Individuals Covered156
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,767
Total amount of fees paid to insurance companyUSD $3,755
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $77,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,767
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number302259
Policy instance 5
Insurance contract or identification number302259
Number of Individuals Covered14
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $414
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $2,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $240
Amount paid for insurance broker fees0
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number24169
Policy instance 4
Insurance contract or identification number24169
Number of Individuals Covered20
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,365
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $8,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,349
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF COLORADO (National Association of Insurance Commissioners NAIC id number: 55875 )
Policy contract numberW1338
Policy instance 3
Insurance contract or identification numberW1338
Number of Individuals Covered200
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 $0
Dental Insurance Welfare BenefitYes
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 number30037307
Policy instance 2
Insurance contract or identification number30037307
Number of Individuals Covered93
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 $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35859
Policy instance 1
Insurance contract or identification number35859
Number of Individuals Covered142
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $20,434
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,014,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,434
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30037307
Policy instance 2
Insurance contract or identification number30037307
Number of Individuals Covered100
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF COLORADO (National Association of Insurance Commissioners NAIC id number: 55875 )
Policy contract numberW1338
Policy instance 3
Insurance contract or identification numberW1338
Number of Individuals Covered213
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
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35859
Policy instance 1
Insurance contract or identification number35859
Number of Individuals Covered164
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $21,248
Total amount of fees paid to insurance companyUSD $1,052
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,154,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,248
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ANKC
Policy instance 6
Insurance contract or identification numberGLUG0ANKC
Number of Individuals Covered162
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,966
Total amount of fees paid to insurance companyUSD $5,525
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $79,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,966
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number302259
Policy instance 5
Insurance contract or identification number302259
Number of Individuals Covered15
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $411
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $2,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $243
Amount paid for insurance broker fees0
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number24169
Policy instance 4
Insurance contract or identification number24169
Number of Individuals Covered34
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,140
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $6,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $994
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35859
Policy instance 1
Insurance contract or identification number35859
Number of Individuals Covered196
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
Welfare Benefit Premiums Paid to CarrierUSD $1,444,609
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 number30037307
Policy instance 2
Insurance contract or identification number30037307
Number of Individuals Covered108
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF COLORADO (National Association of Insurance Commissioners NAIC id number: 55875 )
Policy contract numberW1338
Policy instance 3
Insurance contract or identification numberW1338
Number of Individuals Covered262
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
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number24169
Policy instance 4
Insurance contract or identification number24169
Number of Individuals Covered34
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $869
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $7,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $869
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ANKC
Policy instance 5
Insurance contract or identification numberGLUG0ANKC
Number of Individuals Covered176
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 $8,783
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $85,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees6148
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ANKC
Policy instance 5
Insurance contract or identification numberGLUG0ANKC
Number of Individuals Covered191
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 $6,233
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $87,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees6233
Additional information about fees paid to insurance brokerOTHER COMPENSAITON
Insurance broker organization code?3
DELTA DENTAL OF COLORADO (National Association of Insurance Commissioners NAIC id number: 55875 )
Policy contract number0000W1338
Policy instance 3
Insurance contract or identification number0000W1338
Number of Individuals Covered255
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
Dental Insurance Welfare BenefitYes
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 number30037307
Policy instance 2
Insurance contract or identification number30037307
Number of Individuals Covered106
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35859
Policy instance 1
Insurance contract or identification number35859
Number of Individuals Covered214
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 $4,593
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,331,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees4593
Additional information about fees paid to insurance broker1/15/19 Q4 LARGE GROUP BONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35859
Policy instance 2
Insurance contract or identification number35859
Number of Individuals Covered410
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $573
Total amount of fees paid to insurance companyUSD $3,063
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $1,348,785
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $573
Amount paid for insurance broker fees3009
Additional information about fees paid to insurance brokerQUARTERLY BONUS AND NON-MONETARY COMPENSATION
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number774946
Policy instance 1
Insurance contract or identification number774946
Number of Individuals Covered116
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $82,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ANKC
Policy instance 4
Insurance contract or identification numberGLUG0ANKC
Number of Individuals Covered180
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 $7,175
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $89,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees7175
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30037307
Policy instance 3
Insurance contract or identification number30037307
Number of Individuals Covered104
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number774946
Policy instance 2
Insurance contract or identification number774946
Number of Individuals Covered116
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35859
Policy instance 1
Insurance contract or identification number35859
Number of Individuals Covered410
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $573
Total amount of fees paid to insurance companyUSD $3,063
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,348,785
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $573
Amount paid for insurance broker fees3063
Additional information about fees paid to insurance brokerBONUS/NON MONETARY COMPENSATION
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35859
Policy instance 2
Insurance contract or identification number35859
Number of Individuals Covered255
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 $21,049
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $1,410,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number774946
Policy instance 1
Insurance contract or identification number774946
Number of Individuals Covered134
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $96,345
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 numberEXRK
Policy instance 1
Insurance contract or identification numberEXRK
Number of Individuals Covered183
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $7,890
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $351,557
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,890
Insurance broker organization code?3
Insurance broker nameTHE HAYES GROUP, LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30037307
Policy instance 2
Insurance contract or identification number30037307
Number of Individuals Covered136
Insurance policy end date2015-12-31
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 $20,811
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 number30037307
Policy instance 2
Insurance contract or identification number30037307
Number of Individuals Covered117
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,711
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 numberEXRK
Policy instance 1
Insurance contract or identification numberEXRK
Number of Individuals Covered189
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $8,747
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $342,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,747
Additional information about fees paid to insurance brokerSUPP. COMPENSATION
Insurance broker organization code?3
Insurance broker nameTHE HAYES GROUP, LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30037307
Policy instance 2
Insurance contract or identification number30037307
Number of Individuals Covered105
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $10,495
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees10495
Insurance broker nameTHE HAYES GROUP
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 1
Insurance contract or identification numberEXRK
Number of Individuals Covered173
Insurance policy start date2013-05-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $195,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameTHE HAYES GROUP
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number299-6332
Policy instance 1
Insurance contract or identification number299-6332
Number of Individuals Covered178
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $33,601
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $240,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,601
Insurance broker organization code?3
Insurance broker nameTHE HAYES GROUP
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number299-6332
Policy instance 1
Insurance contract or identification number299-6332
Number of Individuals Covered127
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $28,457
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $196,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number299-6152
Policy instance 1
Insurance contract or identification number299-6152
Number of Individuals Covered129
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $24,699
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $164,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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