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AGBENEFITS 401k Plan overview

Plan NameAGBENEFITS
Plan identification number 501

AGBENEFITS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision

401k Sponsoring company profile

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

Company Name:AGBENEFITS
Employer identification number (EIN):856127618
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AGBENEFITS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-06-01
5012018-06-01
5012012-06-01KIMBERLY TULLO KIMBERLY TULLO2014-01-16
5012011-06-01KIMBERLY TULLO

Plan Statistics for AGBENEFITS

401k plan membership statisitcs for AGBENEFITS

Measure Date Value
2018: AGBENEFITS 2018 401k membership
Total participants, beginning-of-year2018-06-01620
Total number of active participants reported on line 7a of the Form 55002018-06-01649
Number of retired or separated participants receiving benefits2018-06-011
Number of other retired or separated participants entitled to future benefits2018-06-011
Total of all active and inactive participants2018-06-01651
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-06-010
Total participants2018-06-01651
2012: AGBENEFITS 2012 401k membership
Total participants, beginning-of-year2012-06-01523
Total number of active participants reported on line 7a of the Form 55002012-06-01521
Number of retired or separated participants receiving benefits2012-06-012
Number of other retired or separated participants entitled to future benefits2012-06-010
Total of all active and inactive participants2012-06-01523
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-06-010
Total participants2012-06-01523
Number of participants with account balances2012-06-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-06-010
2011: AGBENEFITS 2011 401k membership
Total participants, beginning-of-year2011-06-01592
Total number of active participants reported on line 7a of the Form 55002011-06-01560
Number of retired or separated participants receiving benefits2011-06-012
Number of other retired or separated participants entitled to future benefits2011-06-010
Total of all active and inactive participants2011-06-01562
Total participants2011-06-01562

Financial Data on AGBENEFITS

Measure Date Value
2019 : AGBENEFITS 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$2,019,531
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$1,342,210
Total income from all sources (including contributions)2019-05-31$8,454,385
Total loss/gain on sale of assets2019-05-31$0
Total of all expenses incurred2019-05-31$9,620,036
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-05-31$8,253,015
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-05-31$8,030,367
Value of total assets at end of year2019-05-31$2,207,395
Value of total assets at beginning of year2019-05-31$2,235,190
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-05-31$1,367,021
Total interest from all sources2019-05-31$287,105
Total dividends received (eg from common stock, registered investment company shares)2019-05-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-05-31No
Administrative expenses professional fees incurred2019-05-31$105,083
Was this plan covered by a fidelity bond2019-05-31Yes
Value of fidelity bond cover2019-05-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-05-31No
Contributions received from participants2019-05-31$7,960,126
Assets. Other investments not covered elsewhere at end of year2019-05-31$5,308
Assets. Other investments not covered elsewhere at beginning of year2019-05-31$2,974
Income. Received or receivable in cash from other sources (including rollovers)2019-05-31$70,241
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-05-31$1,303,247
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-05-31$121,510
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-05-31$121,510
Assets. Loans (other than to participants) at end of year2019-05-31$219,644
Assets. Loans (other than to participants) at beginning of year2019-05-31$100,000
Other income not declared elsewhere2019-05-31$136,913
Administrative expenses (other) incurred2019-05-31$1,191,492
Liabilities. Value of operating payables at end of year2019-05-31$1,035,653
Liabilities. Value of operating payables at beginning of year2019-05-31$369,505
Total non interest bearing cash at end of year2019-05-31$239,889
Total non interest bearing cash at beginning of year2019-05-31$363,740
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Value of net income/loss2019-05-31$-1,165,651
Value of net assets at end of year (total assets less liabilities)2019-05-31$187,864
Value of net assets at beginning of year (total assets less liabilities)2019-05-31$892,980
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-05-31No
Were any leases to which the plan was party in default or uncollectible2019-05-31No
Interest earned on other investments2019-05-31$258,850
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-05-31$1,830,800
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-05-31$1,811,814
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-05-31$1,811,814
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-05-31$28,255
Expenses. Payments to insurance carriers foe the provision of benefits2019-05-31$973,008
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-05-31No
Was there a failure to transmit to the plan any participant contributions2019-05-31No
Has the plan failed to provide any benefit when due under the plan2019-05-31No
Assets. Invements in employer securities at end of year2019-05-31$1,100
Assets. Invements in employer securities at beginning of year2019-05-31$1,100
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-05-31$5,976,760
Contract administrator fees2019-05-31$70,446
Liabilities. Value of benefit claims payable at end of year2019-05-31$983,878
Liabilities. Value of benefit claims payable at beginning of year2019-05-31$972,705
Assets. Value of buildings and other operty used in plan operation at end of year2019-05-31$14,096
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-05-31$58,536
Did the plan have assets held for investment2019-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-05-31No
Opinion of an independent qualified public accountant for this plan2019-05-31Unqualified
Accountancy firm name2019-05-31MOSELEY AND RIDDLE
Accountancy firm EIN2019-05-31752759416
2013 : AGBENEFITS 2013 401k financial data
Total transfer of assets to this plan2013-05-31$624,479
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-05-31$633,995
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-05-31$697,588
Expenses. Interest paid2013-05-31$3,421
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022013-05-31$3,421
Total income from all sources (including contributions)2013-05-31$6,456,344
Total loss/gain on sale of assets2013-05-31$9,059
Total of all expenses incurred2013-05-31$5,831,865
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-05-31$4,703,841
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-05-31$5,989,243
Value of total assets at end of year2013-05-31$4,019,702
Value of total assets at beginning of year2013-05-31$3,497,393
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-05-31$1,124,603
Total interest from all sources2013-05-31$42,088
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-05-31No
Administrative expenses professional fees incurred2013-05-31$211,562
Was this plan covered by a fidelity bond2013-05-31No
If this is an individual account plan, was there a blackout period2013-05-31No
Were there any nonexempt tranactions with any party-in-interest2013-05-31No
Participant contributions at end of year2013-05-31$0
Participant contributions at beginning of year2013-05-31$0
Assets. Other investments not covered elsewhere at end of year2013-05-31$8,734
Assets. Other investments not covered elsewhere at beginning of year2013-05-31$9,092
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-05-31$1,282
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-05-31$39,175
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-05-31$178,324
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-05-31$72,476
Other income not declared elsewhere2013-05-31$415,954
Administrative expenses (other) incurred2013-05-31$659,203
Liabilities. Value of operating payables at end of year2013-05-31$7,754
Liabilities. Value of operating payables at beginning of year2013-05-31$17,975
Total non interest bearing cash at end of year2013-05-31$1,080,871
Total non interest bearing cash at beginning of year2013-05-31$474,311
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-05-31No
Value of net income/loss2013-05-31$624,479
Value of net assets at end of year (total assets less liabilities)2013-05-31$3,385,707
Value of net assets at beginning of year (total assets less liabilities)2013-05-31$2,799,805
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-05-31No
Were any leases to which the plan was party in default or uncollectible2013-05-31No
Assets. partnership/joint venture interests at end of year2013-05-31$1,000
Assets. partnership/joint venture interests at beginning of year2013-05-31$1,000
Investment advisory and management fees2013-05-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-05-31$2,901,346
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-05-31$2,903,448
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-05-31$2,903,448
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-05-31$42,088
Expenses. Payments to insurance carriers foe the provision of benefits2013-05-31$703,415
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-05-31No
Was there a failure to transmit to the plan any participant contributions2013-05-31No
Has the plan failed to provide any benefit when due under the plan2013-05-31No
Contributions received in cash from employer2013-05-31$5,989,243
Employer contributions (assets) at end of year2013-05-31$17,679
Employer contributions (assets) at beginning of year2013-05-31$44,672
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-05-31$4,000,426
Contract administrator fees2013-05-31$253,838
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-05-31No
Liabilities. Value of benefit claims payable at end of year2013-05-31$447,917
Liabilities. Value of benefit claims payable at beginning of year2013-05-31$607,137
Assets. Value of buildings and other operty used in plan operation at end of year2013-05-31$8,790
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-05-31$25,695
Did the plan have assets held for investment2013-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-05-31No
Aggregate proceeds on sale of assets2013-05-31$9,059
Liabilities. Value of acquisition indebtedness at end of year2013-05-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-05-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-05-31No
Opinion of an independent qualified public accountant for this plan2013-05-31Qualified
Accountancy firm name2013-05-31MOSELEY AND RIDDLE
Accountancy firm EIN2013-05-31752759416
2012 : AGBENEFITS 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-05-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-05-31$0
Total unrealized appreciation/depreciation of assets2012-05-31$0
Total transfer of assets to this plan2012-05-31$378,385
Total transfer of assets from this plan2012-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-05-31$697,588
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-05-31$566,194
Expenses. Interest paid2012-05-31$5,781
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022012-05-31$5,781
Total income from all sources (including contributions)2012-05-31$6,997,740
Total loss/gain on sale of assets2012-05-31$0
Total of all expenses incurred2012-05-31$6,619,355
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-05-31$5,025,303
Expenses. Certain deemed distributions of participant loans2012-05-31$0
Value of total corrective distributions2012-05-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-05-31$6,295,881
Value of total assets at end of year2012-05-31$3,487,301
Value of total assets at beginning of year2012-05-31$3,397,059
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-05-31$1,588,271
Total income from rents2012-05-31$0
Total interest from all sources2012-05-31$55,951
Total dividends received (eg from common stock, registered investment company shares)2012-05-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-05-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-05-31$0
Assets. Real estate other than employer real property at end of year2012-05-31$0
Assets. Real estate other than employer real property at beginning of year2012-05-31$0
Administrative expenses professional fees incurred2012-05-31$314,142
Assets. Corporate prefeered stocks other than exployer securities at end of year2012-05-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2012-05-31$0
Was this plan covered by a fidelity bond2012-05-31No
If this is an individual account plan, was there a blackout period2012-05-31No
Were there any nonexempt tranactions with any party-in-interest2012-05-31Yes
Amount of non-exempt transactions with any party-in-interest2012-05-31$175,586
Contributions received from participants2012-05-31$0
Participant contributions at end of year2012-05-31$0
Participant contributions at beginning of year2012-05-31$0
Participant contributions at end of year2012-05-31$0
Participant contributions at beginning of year2012-05-31$0
Assets. Other investments not covered elsewhere at end of year2012-05-31$0
Assets. Other investments not covered elsewhere at beginning of year2012-05-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-05-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-05-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-05-31$39,175
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-05-31$100,911
Assets. Loans (other than to participants) at end of year2012-05-31$0
Assets. Loans (other than to participants) at beginning of year2012-05-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-05-31$72,476
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-05-31$75,644
Other income not declared elsewhere2012-05-31$645,908
Administrative expenses (other) incurred2012-05-31$958,259
Liabilities. Value of operating payables at end of year2012-05-31$17,975
Liabilities. Value of operating payables at beginning of year2012-05-31$13,087
Total non interest bearing cash at end of year2012-05-31$474,311
Total non interest bearing cash at beginning of year2012-05-31$354,758
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Income. Non cash contributions2012-05-31$0
Value of net income/loss2012-05-31$378,385
Value of net assets at end of year (total assets less liabilities)2012-05-31$2,789,713
Value of net assets at beginning of year (total assets less liabilities)2012-05-31$2,830,865
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-05-31No
Were any leases to which the plan was party in default or uncollectible2012-05-31No
Assets. partnership/joint venture interests at end of year2012-05-31$0
Assets. partnership/joint venture interests at beginning of year2012-05-31$0
Investment advisory and management fees2012-05-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-05-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-05-31$0
Value of interest in pooled separate accounts at end of year2012-05-31$0
Value of interest in pooled separate accounts at beginning of year2012-05-31$0
Interest on participant loans2012-05-31$0
Income. Interest from loans (other than to participants)2012-05-31$0
Interest earned on other investments2012-05-31$0
Income. Interest from US Government securities2012-05-31$0
Income. Interest from corporate debt instruments2012-05-31$0
Value of interest in master investment trust accounts at end of year2012-05-31$0
Value of interest in master investment trust accounts at beginning of year2012-05-31$0
Value of interest in common/collective trusts at end of year2012-05-31$0
Value of interest in common/collective trusts at beginning of year2012-05-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-05-31$2,903,448
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-05-31$2,902,702
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-05-31$2,902,702
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-05-31$55,951
Assets. Value of investments in 103.12 investment entities at end of year2012-05-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2012-05-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-05-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-05-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-05-31$177,224
Asset value of US Government securities at end of year2012-05-31$0
Asset value of US Government securities at beginning of year2012-05-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-05-31$0
Net investment gain/loss from pooled separate accounts2012-05-31$0
Net investment gain or loss from common/collective trusts2012-05-31$0
Net gain/loss from 103.12 investment entities2012-05-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-05-31No
Was there a failure to transmit to the plan any participant contributions2012-05-31No
Has the plan failed to provide any benefit when due under the plan2012-05-31No
Assets. Invements in employer securities at end of year2012-05-31$0
Assets. Invements in employer securities at beginning of year2012-05-31$0
Assets. Value of employer real property at end of year2012-05-31$0
Assets. Value of employer real property at beginning of year2012-05-31$0
Contributions received in cash from employer2012-05-31$6,295,881
Employer contributions (assets) at end of year2012-05-31$44,672
Employer contributions (assets) at beginning of year2012-05-31$1,523
Income. Dividends from preferred stock2012-05-31$0
Income. Dividends from common stock2012-05-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-05-31$4,848,079
Asset. Corporate debt instrument preferred debt at end of year2012-05-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2012-05-31$0
Asset. Corporate debt instrument debt (other) at end of year2012-05-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2012-05-31$0
Contract administrator fees2012-05-31$315,870
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-05-31No
Assets. Corporate common stocks other than exployer securities at end of year2012-05-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2012-05-31$0
Liabilities. Value of benefit claims payable at end of year2012-05-31$607,137
Liabilities. Value of benefit claims payable at beginning of year2012-05-31$477,463
Assets. Value of buildings and other operty used in plan operation at end of year2012-05-31$25,695
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-05-31$37,165
Did the plan have assets held for investment2012-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-05-31No
Aggregate proceeds on sale of assets2012-05-31$0
Aggregate carrying amount (costs) on sale of assets2012-05-31$0
Liabilities. Value of acquisition indebtedness at end of year2012-05-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-05-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-05-31No
Opinion of an independent qualified public accountant for this plan2012-05-31Qualified
Accountancy firm name2012-05-31MOSELEY AND RIDDLE
Accountancy firm EIN2012-05-31752759416

Form 5500 Responses for AGBENEFITS

2018: AGBENEFITS 2018 form 5500 responses
2018-06-01Type of plan entityMulitple employer plan
2018-06-01First time form 5500 has been submittedYes
2018-06-01Submission has been amendedNo
2018-06-01This submission is the final filingNo
2018-06-01This return/report is a short plan year return/report (less than 12 months)No
2018-06-01Plan is a collectively bargained planNo
2018-06-01Plan funding arrangement – TrustYes
2018-06-01Plan benefit arrangement – InsuranceYes
2018-06-01Plan benefit arrangement - TrustYes
2012: AGBENEFITS 2012 form 5500 responses
2012-06-01Type of plan entityMulitple employer plan
2012-06-01First time form 5500 has been submittedYes
2012-06-01Submission has been amendedNo
2012-06-01This submission is the final filingNo
2012-06-01This return/report is a short plan year return/report (less than 12 months)No
2012-06-01Plan is a collectively bargained planNo
2012-06-01Plan funding arrangement – TrustYes
2012-06-01Plan benefit arrangement – InsuranceYes
2012-06-01Plan benefit arrangement - TrustYes
2011: AGBENEFITS 2011 form 5500 responses
2011-06-01Type of plan entityMulitple employer plan
2011-06-01First time form 5500 has been submittedYes
2011-06-01Submission has been amendedNo
2011-06-01This submission is the final filingNo
2011-06-01This return/report is a short plan year return/report (less than 12 months)No
2011-06-01Plan is a collectively bargained planNo
2011-06-01Plan funding arrangement – TrustYes
2011-06-01Plan benefit arrangement – InsuranceYes
2011-06-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010039424
Policy instance 2
Insurance contract or identification number010039424
Number of Individuals Covered1053
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $91,791
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $91,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VISION BENEFITS
Commission paid to Insurance BrokerUSD $91,791
Insurance broker organization code?5
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 139046
Policy instance 1
Insurance contract or identification numberGL 139046
Number of Individuals Covered766
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $131,519
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $131,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP LIFE BENEFITS
Commission paid to Insurance BrokerUSD $131,519
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1000498
Policy instance 3
Insurance contract or identification number1000498
Number of Individuals Covered1053
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,160,586
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP TRANSPLANT POLICY
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 $51,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP TRANSPLANT POLICY
Commission paid to Insurance BrokerUSD $51,605
Insurance broker organization code?5
GREENWICH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22322 )
Policy contract numberNUGIC-1025-17
Policy instance 4
Insurance contract or identification numberNUGIC-1025-17
Number of Individuals Covered1053
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $909,050
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractSTOP LOSS/REINSURANCE
Commission paid to Insurance BrokerUSD $909,050
Insurance broker organization code?5
RELIANCE STANDARD (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 139046
Policy instance 1
Insurance contract or identification numberGL 139046
Number of Individuals Covered766
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $131,519
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $131,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP LIFE BENEFITS
Commission paid to Insurance BrokerUSD $131,519

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