STAR-JOURNAL PUBLISHING CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN
401k plan membership statisitcs for STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN
Measure | Date | Value |
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2018: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 135 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 78 |
Total of all active and inactive participants | 2018-01-01 | 78 |
Total participants | 2018-01-01 | 78 |
2017: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 205 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 135 |
Total of all active and inactive participants | 2017-01-01 | 135 |
Total participants | 2017-01-01 | 135 |
2016: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 155 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 205 |
Total of all active and inactive participants | 2016-01-01 | 205 |
Total participants | 2016-01-01 | 205 |
2015: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 169 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 155 |
Total of all active and inactive participants | 2015-01-01 | 155 |
Total participants | 2015-01-01 | 0 |
2014: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 171 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 169 |
Total of all active and inactive participants | 2014-01-01 | 169 |
Total participants | 2014-01-01 | 0 |
2013: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 206 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 171 |
Total of all active and inactive participants | 2013-01-01 | 171 |
Total participants | 2013-01-01 | 0 |
2012: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 125 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 206 |
Total of all active and inactive participants | 2012-01-01 | 206 |
Total participants | 2012-01-01 | 0 |
2011: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 125 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 127 |
Total of all active and inactive participants | 2011-01-01 | 127 |
Total participants | 2011-01-01 | 127 |
2010: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-01-01 | 130 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 125 |
Total of all active and inactive participants | 2010-01-01 | 125 |
Total participants | 2010-01-01 | 125 |
2009: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 159 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 130 |
Total of all active and inactive participants | 2009-01-01 | 130 |
Total participants | 2009-01-01 | 130 |
2018: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | This submission is the final filing | Yes |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2010: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2010 form 5500 responses |
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2010-01-01 | Type of plan entity | Single employer plan |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: STAR JOURNAL PUBLISHING DBA THE PUEBLO CHIEFTAIN HEALTH CARE PLAN 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5925647 |
Policy instance | 4 |
Insurance contract or identification number | 5925647 | Number of Individuals Covered | 39 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,180 | Total amount of fees paid to insurance company | USD $320 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,892 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $695 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 118 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010186912 |
Policy instance | 3 |
Insurance contract or identification number | 000010186912 | Number of Individuals Covered | 52 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $410 | Total amount of fees paid to insurance company | USD $103 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,914 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $410 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 103 | Additional information about fees paid to insurance broker | BROKER BONUS |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30037747 |
Policy instance | 2 |
Insurance contract or identification number | 30037747 | Number of Individuals Covered | 58 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $475 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,748 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $475 | Insurance broker organization code? | 3 |
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ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) |
Policy contract number | 195986 |
Policy instance | 1 |
Insurance contract or identification number | 195986 | Number of Individuals Covered | 78 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $17,340 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $438,614 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,464 | Insurance broker organization code? | 3 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30037747 |
Policy instance | 2 |
Insurance contract or identification number | 30037747 | Number of Individuals Covered | 69 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $781 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,879 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $781 | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL INSURANCE SVC INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010186912 |
Policy instance | 3 |
Insurance contract or identification number | 000010186912 | Number of Individuals Covered | 54 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $865 | Total amount of fees paid to insurance company | USD $215 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,868 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $688 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 215 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | HUB INTERNATIONAL INS SVCS INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TS05925647 |
Policy instance | 4 |
Insurance contract or identification number | TS05925647 | Number of Individuals Covered | 48 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,399 | Total amount of fees paid to insurance company | USD $655 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,365 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,001 | Amount paid for insurance broker fees | 80 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL INS SERVICES INC |
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BETA HEALTH ASSOCIATION, INC. (National Association of Insurance Commissioners NAIC id number: 81300 ) |
Policy contract number | 1734000 |
Policy instance | 5 |
Insurance contract or identification number | 1734000 | Number of Individuals Covered | 44 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $902 | Welfare Benefit Premiums Paid to Carrier | USD $9,492 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $902 | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL INSURANCE SVC INC |
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ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) |
Policy contract number | 195986 |
Policy instance | 1 |
Insurance contract or identification number | 195986 | Number of Individuals Covered | 135 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $37,738 | Total amount of fees paid to insurance company | USD $1,133 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $886,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $37,738 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1133 | Additional information about fees paid to insurance broker | FEES | Insurance broker name | HUB INTERNATIONAL INSURANCE SVC INC |
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ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) |
Policy contract number | 195986 |
Policy instance | 1 |
Insurance contract or identification number | 195986 | Number of Individuals Covered | 155 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $39,925 | Total amount of fees paid to insurance company | USD $445 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $816,855 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,925 | Amount paid for insurance broker fees | 274 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | INTERACTIVE INSURANCE SOLUTIONS INC |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30037747 |
Policy instance | 2 |
Insurance contract or identification number | 30037747 | Number of Individuals Covered | 68 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $786 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,021 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $786 | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL SERVICES, INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010186912 |
Policy instance | 3 |
Insurance contract or identification number | 000010186912 | Number of Individuals Covered | 65 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $887 | Total amount of fees paid to insurance company | USD $145 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,067 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $887 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 145 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | HUB INTERNATIONAL MIDWEST LTD |
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BETA HEALTH ASSOCIATION, INC. (National Association of Insurance Commissioners NAIC id number: 81300 ) |
Policy contract number | 1734000 |
Policy instance | 4 |
Insurance contract or identification number | 1734000 | Number of Individuals Covered | 49 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,116 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,752 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,116 | Insurance broker name | HUB INTERNATIONAL INSURANCE |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30037747 |
Policy instance | 2 |
Insurance contract or identification number | 30037747 | Number of Individuals Covered | 72 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $802 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,464 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $802 | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL SERVICES, INC. |
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ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) |
Policy contract number | 195986 |
Policy instance | 1 |
Insurance contract or identification number | 195986 | Number of Individuals Covered | 169 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $44,021 | Total amount of fees paid to insurance company | USD $708 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $881,909 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,021 | Amount paid for insurance broker fees | 708 | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, COMMUNICATION AND TRAINING | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL INSURANCE |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010186912 |
Policy instance | 3 |
Insurance contract or identification number | 000010186912 | Number of Individuals Covered | 73 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $817 | Total amount of fees paid to insurance company | USD $187 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,425 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $817 | Amount paid for insurance broker fees | 187 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL INS SVCS INC. |
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ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) |
Policy contract number | 195986 |
Policy instance | 3 |
Insurance contract or identification number | 195986 | Number of Individuals Covered | 171 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $34,545 | Total amount of fees paid to insurance company | USD $1,114 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $724,682 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,545 | Amount paid for insurance broker fees | 1114 | Additional information about fees paid to insurance broker | INCENTIVES,EDUCATION, COMMUNICATION AND TRAINING | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL SERVICES, INC. |
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BETA HEALTH ASSOCIATION, INC. (National Association of Insurance Commissioners NAIC id number: 81300 ) |
Policy contract number | 1734000 |
Policy instance | 2 |
Insurance contract or identification number | 1734000 | Number of Individuals Covered | 54 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $1,139 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,991 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $770 | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL INSURANCE |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 1110474376000 |
Policy instance | 1 |
Insurance contract or identification number | 1110474376000 | Number of Individuals Covered | 20 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $2,485 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,453 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,952 | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL INS SVCS INC. |
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BETA HEALTH ASSOCIATION, INC. (National Association of Insurance Commissioners NAIC id number: 81300 ) |
Policy contract number | 1734000 |
Policy instance | 1 |
Insurance contract or identification number | 1734000 | Number of Individuals Covered | 50 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $1,219 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,830 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,219 | Insurance broker organization code? | 3 | Insurance broker name | D.B. GOLENDA INSURANCE INC. |
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KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 ) |
Policy contract number | 49691 |
Policy instance | 3 |
Insurance contract or identification number | 49691 | Number of Individuals Covered | 206 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $32,817 | Total amount of fees paid to insurance company | USD $2,728 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $968,787 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,817 | Amount paid for insurance broker fees | 2728 | Additional information about fees paid to insurance broker | RETENTION | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 1110474376000 |
Policy instance | 2 |
Insurance contract or identification number | 1110474376000 | Number of Individuals Covered | 20 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $2,192 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,676 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,192 | Insurance broker organization code? | 3 | Insurance broker name | BETA HEALTH ASSOCIATES, INC |
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CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 358270 |
Policy instance | 3 |
Insurance contract or identification number | 358270 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $51,355 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12231323 |
Policy instance | 2 |
Insurance contract or identification number | 12231323 | Number of Individuals Covered | 125 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $529 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,573 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 ) |
Policy contract number | 49691 |
Policy instance | 1 |
Insurance contract or identification number | 49691 | Number of Individuals Covered | 127 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $31,123 | Total amount of fees paid to insurance company | USD $13,205 | Welfare Benefit Premiums Paid to Carrier | USD $1,247,082 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 358270 |
Policy instance | 2 |
Insurance contract or identification number | 358270 | Number of Individuals Covered | 125 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $31,854 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $325,751 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,854 | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL SOUTHWEST AGENCY |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12231323 |
Policy instance | 1 |
Insurance contract or identification number | 12231323 | Number of Individuals Covered | 129 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $537 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,730 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $537 | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL SOUTHWEST AGENCY |
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