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BERTHOD MOTORS, INC. HEALTH PLAN 401k Plan overview

Plan NameBERTHOD MOTORS, INC. HEALTH PLAN
Plan identification number 502

BERTHOD MOTORS, INC. HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Long-term disability cover

401k Sponsoring company profile

BERTHOD MOTORS, INC. has sponsored the creation of one or more 401k plans.

Company Name:BERTHOD MOTORS, INC.
Employer identification number (EIN):840498295
NAIC Classification:441110
NAIC Description:New Car Dealers

Additional information about BERTHOD MOTORS, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1963-09-09
Company Identification Number: 19871168798
Legal Registered Office Address: 2914 Grand Ave

Glenwood Springs
United States of America (USA)
81601

More information about BERTHOD MOTORS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BERTHOD MOTORS, INC. HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-06-01
5022021-06-01
5022020-06-01
5022019-06-01
5022018-06-01
5022017-06-01A1358393 DONALD GERBAZ2019-02-20
5022016-06-01DONALD GERBAZ DONALD GERBAZ2017-09-13
5022015-06-01DONALD GERBAZ DONALD GERBAZ2016-08-23
5022014-06-01DONALD GERBAZ DONALD GERBAZ2016-02-05
5022013-06-01DONALD GERBAZ DONALD GERBAZ2015-03-13
5022012-06-01DONALD GERBAZ DONALD GERBAZ2013-12-23
5022011-06-01DONALD GERBAZ DONALD GERBAZ2013-02-26
5022010-06-01DONALD GERBAZ DONALD GERBAZ2012-03-14
5022009-06-01DONALD GERBAZ DONALD GERBAZ2011-03-03

Plan Statistics for BERTHOD MOTORS, INC. HEALTH PLAN

401k plan membership statisitcs for BERTHOD MOTORS, INC. HEALTH PLAN

Measure Date Value
2022: BERTHOD MOTORS, INC. HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-0152
Total number of active participants reported on line 7a of the Form 55002022-06-0137
Number of retired or separated participants receiving benefits2022-06-010
Total of all active and inactive participants2022-06-0137
2021: BERTHOD MOTORS, INC. HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-0161
Total number of active participants reported on line 7a of the Form 55002021-06-0152
Number of retired or separated participants receiving benefits2021-06-011
Total of all active and inactive participants2021-06-0153
2020: BERTHOD MOTORS, INC. HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-0162
Total number of active participants reported on line 7a of the Form 55002020-06-0161
Total of all active and inactive participants2020-06-0161
2019: BERTHOD MOTORS, INC. HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-0162
Total number of active participants reported on line 7a of the Form 55002019-06-0162
Total of all active and inactive participants2019-06-0162
2018: BERTHOD MOTORS, INC. HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-0168
Total number of active participants reported on line 7a of the Form 55002018-06-0162
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-0162
2017: BERTHOD MOTORS, INC. HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-0182
Total number of active participants reported on line 7a of the Form 55002017-06-0168
Number of retired or separated participants receiving benefits2017-06-010
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-0168
2016: BERTHOD MOTORS, INC. HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-0171
Total number of active participants reported on line 7a of the Form 55002016-06-0182
Total of all active and inactive participants2016-06-0182
2015: BERTHOD MOTORS, INC. HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-0168
Total number of active participants reported on line 7a of the Form 55002015-06-0171
Total of all active and inactive participants2015-06-0171
2014: BERTHOD MOTORS, INC. HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-0167
Total number of active participants reported on line 7a of the Form 55002014-06-0168
Total of all active and inactive participants2014-06-0168
2013: BERTHOD MOTORS, INC. HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-0158
Total number of active participants reported on line 7a of the Form 55002013-06-0167
Total of all active and inactive participants2013-06-0167
2012: BERTHOD MOTORS, INC. HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-0153
Total number of active participants reported on line 7a of the Form 55002012-06-0158
Number of retired or separated participants receiving benefits2012-06-010
Number of other retired or separated participants entitled to future benefits2012-06-010
Total of all active and inactive participants2012-06-0158
2011: BERTHOD MOTORS, INC. HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-0158
Total number of active participants reported on line 7a of the Form 55002011-06-0153
Number of retired or separated participants receiving benefits2011-06-010
Number of other retired or separated participants entitled to future benefits2011-06-010
Total of all active and inactive participants2011-06-0153
2010: BERTHOD MOTORS, INC. HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-06-0167
Total number of active participants reported on line 7a of the Form 55002010-06-0158
Number of retired or separated participants receiving benefits2010-06-010
Total of all active and inactive participants2010-06-0158
2009: BERTHOD MOTORS, INC. HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-0180
Total number of active participants reported on line 7a of the Form 55002009-06-0167
Number of retired or separated participants receiving benefits2009-06-010
Total of all active and inactive participants2009-06-0167
Total participants2009-06-0167

Financial Data on BERTHOD MOTORS, INC. HEALTH PLAN

Measure Date Value
2023 : BERTHOD MOTORS, INC. HEALTH PLAN 2023 401k financial data
Total income from all sources2023-05-31$771,543
Expenses. Total of all expenses incurred2023-05-31$778,528
Benefits paid (including direct rollovers)2023-05-31$718,115
Total plan assets at end of year2023-05-31$20,907
Total plan assets at beginning of year2023-05-31$27,892
Total contributions received or receivable from participants2023-05-31$105,321
Net income (gross income less expenses)2023-05-31$-6,985
Net plan assets at end of year (total assets less liabilities)2023-05-31$20,907
Net plan assets at beginning of year (total assets less liabilities)2023-05-31$27,892
Total contributions received or receivable from employer(s)2023-05-31$666,222
Expenses. Administrative service providers (salaries,fees and commissions)2023-05-31$60,413
2022 : BERTHOD MOTORS, INC. HEALTH PLAN 2022 401k financial data
Total income from all sources2022-05-31$539,257
Expenses. Total of all expenses incurred2022-05-31$554,161
Benefits paid (including direct rollovers)2022-05-31$487,265
Total plan assets at end of year2022-05-31$27,892
Total plan assets at beginning of year2022-05-31$42,796
Total contributions received or receivable from participants2022-05-31$83,524
Net income (gross income less expenses)2022-05-31$-14,904
Net plan assets at end of year (total assets less liabilities)2022-05-31$27,892
Net plan assets at beginning of year (total assets less liabilities)2022-05-31$42,796
Total contributions received or receivable from employer(s)2022-05-31$455,733
Expenses. Administrative service providers (salaries,fees and commissions)2022-05-31$66,896
2021 : BERTHOD MOTORS, INC. HEALTH PLAN 2021 401k financial data
Total income from all sources2021-05-31$1,109,339
Expenses. Total of all expenses incurred2021-05-31$1,122,187
Benefits paid (including direct rollovers)2021-05-31$1,040,998
Total plan assets at end of year2021-05-31$42,796
Total plan assets at beginning of year2021-05-31$55,644
Total contributions received or receivable from participants2021-05-31$62,771
Expenses. Other expenses not covered elsewhere2021-05-31$90
Net income (gross income less expenses)2021-05-31$-12,848
Net plan assets at end of year (total assets less liabilities)2021-05-31$42,796
Net plan assets at beginning of year (total assets less liabilities)2021-05-31$55,644
Total contributions received or receivable from employer(s)2021-05-31$1,046,568
Expenses. Administrative service providers (salaries,fees and commissions)2021-05-31$81,099
2020 : BERTHOD MOTORS, INC. HEALTH PLAN 2020 401k financial data
Total income from all sources2020-05-31$714,305
Expenses. Total of all expenses incurred2020-05-31$678,339
Benefits paid (including direct rollovers)2020-05-31$596,562
Total plan assets at end of year2020-05-31$55,644
Total plan assets at beginning of year2020-05-31$19,678
Total contributions received or receivable from participants2020-05-31$53,325
Net income (gross income less expenses)2020-05-31$35,966
Net plan assets at end of year (total assets less liabilities)2020-05-31$55,644
Net plan assets at beginning of year (total assets less liabilities)2020-05-31$19,678
Total contributions received or receivable from employer(s)2020-05-31$660,980
Expenses. Administrative service providers (salaries,fees and commissions)2020-05-31$81,777
2018 : BERTHOD MOTORS, INC. HEALTH PLAN 2018 401k financial data
Total plan liabilities at end of year2018-05-31$0
Total plan liabilities at beginning of year2018-05-31$100,000
Total income from all sources2018-05-31$811,352
Expenses. Total of all expenses incurred2018-05-31$774,594
Benefits paid (including direct rollovers)2018-05-31$498,019
Total plan assets at end of year2018-05-31$78,989
Total plan assets at beginning of year2018-05-31$142,231
Total contributions received or receivable from participants2018-05-31$47,323
Expenses. Other expenses not covered elsewhere2018-05-31$198,159
Other income received2018-05-31$68
Net income (gross income less expenses)2018-05-31$36,758
Net plan assets at end of year (total assets less liabilities)2018-05-31$78,989
Net plan assets at beginning of year (total assets less liabilities)2018-05-31$42,231
Total contributions received or receivable from employer(s)2018-05-31$763,961
Expenses. Administrative service providers (salaries,fees and commissions)2018-05-31$78,416
2017 : BERTHOD MOTORS, INC. HEALTH PLAN 2017 401k financial data
Total plan liabilities at end of year2017-05-31$100,000
Total income from all sources2017-05-31$857,761
Expenses. Total of all expenses incurred2017-05-31$875,753
Benefits paid (including direct rollovers)2017-05-31$789,178
Total plan assets at end of year2017-05-31$142,231
Total plan assets at beginning of year2017-05-31$60,223
Total contributions received or receivable from participants2017-05-31$64,919
Expenses. Other expenses not covered elsewhere2017-05-31$18,153
Other income received2017-05-31$161
Net income (gross income less expenses)2017-05-31$-17,992
Net plan assets at end of year (total assets less liabilities)2017-05-31$42,231
Net plan assets at beginning of year (total assets less liabilities)2017-05-31$60,223
Total contributions received or receivable from employer(s)2017-05-31$792,681
Expenses. Administrative service providers (salaries,fees and commissions)2017-05-31$68,422
2016 : BERTHOD MOTORS, INC. HEALTH PLAN 2016 401k financial data
Total income from all sources2016-05-31$617,514
Expenses. Total of all expenses incurred2016-05-31$617,329
Benefits paid (including direct rollovers)2016-05-31$545,977
Total plan assets at end of year2016-05-31$60,223
Total plan assets at beginning of year2016-05-31$60,038
Total contributions received or receivable from participants2016-05-31$42,920
Other income received2016-05-31$184
Net income (gross income less expenses)2016-05-31$185
Net plan assets at end of year (total assets less liabilities)2016-05-31$60,223
Net plan assets at beginning of year (total assets less liabilities)2016-05-31$60,038
Total contributions received or receivable from employer(s)2016-05-31$574,410
Expenses. Administrative service providers (salaries,fees and commissions)2016-05-31$71,352
2015 : BERTHOD MOTORS, INC. HEALTH PLAN 2015 401k financial data
Total income from all sources2015-05-31$629,588
Expenses. Total of all expenses incurred2015-05-31$629,393
Benefits paid (including direct rollovers)2015-05-31$563,912
Total plan assets at end of year2015-05-31$60,038
Total plan assets at beginning of year2015-05-31$59,843
Total contributions received or receivable from participants2015-05-31$39,960
Other income received2015-05-31$195
Net income (gross income less expenses)2015-05-31$195
Net plan assets at end of year (total assets less liabilities)2015-05-31$60,038
Net plan assets at beginning of year (total assets less liabilities)2015-05-31$59,843
Total contributions received or receivable from employer(s)2015-05-31$589,433
Expenses. Administrative service providers (salaries,fees and commissions)2015-05-31$65,481
2014 : BERTHOD MOTORS, INC. HEALTH PLAN 2014 401k financial data
Total income from all sources2014-05-31$611,313
Expenses. Total of all expenses incurred2014-05-31$611,124
Benefits paid (including direct rollovers)2014-05-31$553,735
Total plan assets at end of year2014-05-31$59,843
Total plan assets at beginning of year2014-05-31$59,654
Total contributions received or receivable from participants2014-05-31$53,158
Other income received2014-05-31$189
Net income (gross income less expenses)2014-05-31$189
Net plan assets at end of year (total assets less liabilities)2014-05-31$59,843
Net plan assets at beginning of year (total assets less liabilities)2014-05-31$59,654
Total contributions received or receivable from employer(s)2014-05-31$557,966
Expenses. Administrative service providers (salaries,fees and commissions)2014-05-31$57,389
2013 : BERTHOD MOTORS, INC. HEALTH PLAN 2013 401k financial data
Total income from all sources2013-05-31$380,902
Expenses. Total of all expenses incurred2013-05-31$377,627
Benefits paid (including direct rollovers)2013-05-31$311,766
Total plan assets at end of year2013-05-31$59,654
Total plan assets at beginning of year2013-05-31$56,379
Total contributions received or receivable from participants2013-05-31$66,013
Other income received2013-05-31$275
Net income (gross income less expenses)2013-05-31$3,275
Net plan assets at end of year (total assets less liabilities)2013-05-31$59,654
Net plan assets at beginning of year (total assets less liabilities)2013-05-31$56,379
Total contributions received or receivable from employer(s)2013-05-31$314,614
Expenses. Administrative service providers (salaries,fees and commissions)2013-05-31$65,861
2012 : BERTHOD MOTORS, INC. HEALTH PLAN 2012 401k financial data
Total income from all sources2012-05-31$370,272
Expenses. Total of all expenses incurred2012-05-31$372,904
Benefits paid (including direct rollovers)2012-05-31$305,536
Total plan assets at end of year2012-05-31$56,379
Total plan assets at beginning of year2012-05-31$59,011
Total contributions received or receivable from participants2012-05-31$59,203
Other income received2012-05-31$368
Net income (gross income less expenses)2012-05-31$-2,632
Net plan assets at end of year (total assets less liabilities)2012-05-31$56,379
Net plan assets at beginning of year (total assets less liabilities)2012-05-31$59,011
Total contributions received or receivable from employer(s)2012-05-31$310,701
Expenses. Administrative service providers (salaries,fees and commissions)2012-05-31$67,368
2011 : BERTHOD MOTORS, INC. HEALTH PLAN 2011 401k financial data
Total income from all sources2011-05-31$565,074
Expenses. Total of all expenses incurred2011-05-31$564,577
Benefits paid (including direct rollovers)2011-05-31$511,506
Total plan assets at end of year2011-05-31$59,011
Total plan assets at beginning of year2011-05-31$58,514
Total contributions received or receivable from participants2011-05-31$58,235
Other income received2011-05-31$497
Net income (gross income less expenses)2011-05-31$497
Net plan assets at end of year (total assets less liabilities)2011-05-31$59,011
Net plan assets at beginning of year (total assets less liabilities)2011-05-31$58,514
Total contributions received or receivable from employer(s)2011-05-31$506,342
Expenses. Administrative service providers (salaries,fees and commissions)2011-05-31$53,071

Form 5500 Responses for BERTHOD MOTORS, INC. HEALTH PLAN

2022: BERTHOD MOTORS, INC. HEALTH PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – General assets of the sponsorYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – General assets of the sponsorYes
2021: BERTHOD MOTORS, INC. HEALTH PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – General assets of the sponsorYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – General assets of the sponsorYes
2020: BERTHOD MOTORS, INC. HEALTH PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – General assets of the sponsorYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – General assets of the sponsorYes
2019: BERTHOD MOTORS, INC. HEALTH PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – General assets of the sponsorYes
2019-06-01Plan benefit arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – General assets of the sponsorYes
2018: BERTHOD MOTORS, INC. HEALTH PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – General assets of the sponsorYes
2018-06-01Plan benefit arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – General assets of the sponsorYes
2017: BERTHOD MOTORS, INC. HEALTH PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – General assets of the sponsorYes
2017-06-01Plan benefit arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – General assets of the sponsorYes
2016: BERTHOD MOTORS, INC. HEALTH PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – General assets of the sponsorYes
2016-06-01Plan benefit arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – General assets of the sponsorYes
2015: BERTHOD MOTORS, INC. HEALTH PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – General assets of the sponsorYes
2015-06-01Plan benefit arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – General assets of the sponsorYes
2014: BERTHOD MOTORS, INC. HEALTH PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – General assets of the sponsorYes
2014-06-01Plan benefit arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – General assets of the sponsorYes
2013: BERTHOD MOTORS, INC. HEALTH PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Plan funding arrangement – General assets of the sponsorYes
2013-06-01Plan benefit arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – General assets of the sponsorYes
2012: BERTHOD MOTORS, INC. HEALTH PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Plan funding arrangement – General assets of the sponsorYes
2012-06-01Plan benefit arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – General assets of the sponsorYes
2011: BERTHOD MOTORS, INC. HEALTH PLAN 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Plan funding arrangement – General assets of the sponsorYes
2011-06-01Plan benefit arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – General assets of the sponsorYes
2010: BERTHOD MOTORS, INC. HEALTH PLAN 2010 form 5500 responses
2010-06-01Type of plan entitySingle employer plan
2010-06-01Plan funding arrangement – General assets of the sponsorYes
2010-06-01Plan benefit arrangement – InsuranceYes
2010-06-01Plan benefit arrangement – General assets of the sponsorYes
2009: BERTHOD MOTORS, INC. HEALTH PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01This submission is the final filingNo
2009-06-01Plan funding arrangement – General assets of the sponsorYes
2009-06-01Plan benefit arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417007412900
Policy instance 1
Insurance contract or identification number417007412900
Number of Individuals Covered37
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $60,413
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $218,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees45353
Additional information about fees paid to insurance brokerADMINISTRATION OF THE PLAN.
Insurance broker organization code?3
ACE BENEFIT PARTNERS INC (National Association of Insurance Commissioners NAIC id number: )
Policy contract number417006412900
Policy instance 1
Insurance contract or identification number417006412900
Number of Individuals Covered46
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $17,310
Total amount of fees paid to insurance companyUSD $49,586
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $232,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees49586
Additional information about fees paid to insurance brokerADMINISTRATION OF THE PLAN.
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $17,310
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number417004412900
Policy instance 1
Insurance contract or identification number417004412900
Number of Individuals Covered56
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $21,870
Total amount of fees paid to insurance companyUSD $59,229
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $256,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees59229
Additional information about fees paid to insurance brokerADMINISTRATION OF THE PLAN.
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $21,870
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417003412900
Policy instance 1
Insurance contract or identification number417003412900
Number of Individuals Covered62
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $21,300
Total amount of fees paid to insurance companyUSD $60,477
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $232,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees60477
Additional information about fees paid to insurance brokerADMINISTRATION OF THE PLAN.
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $21,300
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417003412900
Policy instance 1
Insurance contract or identification number417003412900
Number of Individuals Covered62
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $22,500
Total amount of fees paid to insurance companyUSD $55,294
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees55294
Additional information about fees paid to insurance brokerADMINISTRATION OF THE PLAN.
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $22,500
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417003412900
Policy instance 1
Insurance contract or identification number417003412900
Number of Individuals Covered68
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $24,390
Total amount of fees paid to insurance companyUSD $54,026
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $68,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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